Laparoscopic Myomectomy

Laparoscopic Myomectomy

What is it?

Fibroids can also be removed without incision (closed surgery) by laparoscopy or with a surgical robot.
Keyhole surgery (through the abdomen) to remove fibroids.

What types of fibroids does it treat?

Recommended for fewer than 4 fibroids and fibroids that are less than 10cm wide.

Certain subserosal fibroids may be removed via laparoscope.

How is it done?

A laparoscope (telescope) is inserted into the womb through a tiny cut in the belly button.
Other small cuts are made in the same area in the abdominal wall to insert instruments that slice up and remove the fibroids.
Once the fibroids are removed they are cut into pieces by one of several instruments designed for this purpose, and removed.
This is done under general anaesthetic and you will be in hospital for a day or two.

What is the recovery period afterwards?

It is usually done as an outpatient, and allows faster recovery than a laparotomy.
The surgery may take longer but recovery is much quicker than abdominal myomectomy.
Recovery at home takes 7 to 14 days.

Will the fibroids come back?

This procedure may not remove all fibroids.
Any missed fibroids are likely to continue to grow.
New fibroids may also develop.

Will I still be able to get pregnant?

Laparoscopic myomectomy does not usually interfere with fertility.
However, if a woman plans pregnancy after her myomectomy, there is a question of whether the uterus can be repaired through the laparoscope as well as it can be by laparotomy.
There may be an increased risk of your womb rupturing during pregnancy.

 

What are the advantages of this procedure?

Less invasive than other surgical options; small abdominal scars and little scarring inside the womb.
It is easier to remove fibroids by laparoscopy when the they are on a stalk or close to the surface.

What are the possible complications?

Unexpected complications may require an abdominal myomectomy or emergency hysterectomy.

What are the other disadvantages?

It is a difficult, often long, procedure and requires a highly skilled surgeon.
Extended time needed to remove large fibroids from the abdomen, although newer instruments are improving this. 
Since the surgeon cannot actually touch the uterus, it may be more difficult to detect and remove smaller myomas.