Abdominal (Laparotomic) Myomectomy
What is it?
Open surgery to remove fibroids (laparotomy).
What types of fibroids does it treat?
Can remove fibroids in the wall of the womb (intramural) and in the outer layer of the womb (subserous).
How is it done?
A 15cm cut is made in the abdomen for the doctor to shell out the fibroids.
This is done with a looped wire, knife or laser.
Once the fibroids have been removed, the uterus and abdomen are stitched up.
The operation requires general anaesthetic and you will be in hospital for a few days.
What is the recovery period afterwards?
It will take about a month or more to recover at home.
You will probably feel tired and weak and will need to regain your strength by walking and doing specific exercises.
Do not lift heavy objects while recovering.
Will the fibroids come back?
Some studies show a 10 to 15% chance of fibroid regrowth, while others estimate 30%.
In black women, regrowth may be as high as 50%.
Will I still be able to get pregnant?
Most women can still become pregnant after a myomectomy, but in some cases scarring in the womb can cause fertility problems.
What are the advantages of this procedure?
Large fibroids can be quickly removed.
The surgeon is able to feel the uterus, which is helpful in locating myomas that may be deep in the uterine wall.
The ability to touch the uterus facilitates repairing the uterus.
Your womb is left intact and you may still be able to have children.
What are the possible complications?
Bleeding that can lead to an emergency hysterectomy.
Infection; damage to surrounding organs.
What are the other disadvantages?
It requires an abdominal incision.
Most of the patients spend 2 nights in the hospital, and return to work in about 4 weeks.
Possible weakening of the womb wall and scarring may cause complications during pregnancy such as rupturing of the womb wall.
20 to 25% of women undergo additional surgery, usually hysterectomy, to stop symptoms.