Laparoscopic Myomectomy for Fibroid Removal (Scarless)

Laparoscopic Myomectomy is a procedure used to remove the Fibroids present in the walls of the Uterus.


1-2 hrs

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Uterine fibroids

Fibroids are harmless tumors present along the walls of the uterus. It is a very common occurrence for fertile women. These tumors arise from the muscle layer of the uterus and the size of uterine fibroids may range from few centimeters to as large as a melon.

Understanding laparoscopic myomectomy

The prefix “My-” means muscle. Since fibroids arise from the muscle layer of the uterus, it is also called as “Myoma”. “Ectomy” is removal. Hence the name “Myomectomy”. There are 2 ways by which this can be done: One is scooping out of the whole fibroid and removing it from the vagina, as if delivering a baby. The other one is the laparoscopic technique, in which the fibroid is minced into tiny pieces with help of a special instrument (morcellator), and these pieces are extracted out of the abdomen through abdominal ports.

How is laparoscopic myomectomy Performed

Morcellation 

A tiny incision is made over the umbilicus. Operating port is inserted through this incision.

Special surgical instruments are inserted through this port.

The uterus and surrounding organs are visualized.

Once the fibroid is identified, a morcellator is inserted.

Using the morcellator, the fibroid is minced into tiny pieces.

The minced pieces are extracted out through one of the ports.

The abdomen is cleaned. Control of bleeding is ensured.

Since the whole procedure is done through the umbilicus, it is virtually scar-less.

Removal of fibroid from natural orifice itself

Two tiny incisions are made on the abdomen.

Operating ports are inserted through these incisions.

Special surgical instuments are inserted through the ports.

The uterus and surrounding organs are visualized and the fibroid is identified.

A laser is used to slowly cut the top layer of the uterus until it reaches the fibroid.

The fibroid is then scooped out from the womb. Simultaneously control of bleeding is ensured.

The scooped out fibroid is then removed through a small incision made in the vagina.

The womb and vagina is sutured back.

This technique is usually preferred for large fibroids.

Laparoscopic myomectomy

Life After LAPAROSCOPIC MYOMECTOMY

Patients are very much relieved from the pain and discomfort that follows every menstrual cycle. Moreover, the women’s infertility issues will be resolved.

Treatment window

Fibroids are harmless growths in the uterus. So surgeons choose to wait and watch if there are no symptoms. But once the symptoms arise, it is better to get it surgically treated because severe bleeding due to fibroids can also lead to anemia and weakness in women.

laparoscopic myomectomy FAQ

Fibroids are benign tumours that are made up of muscles that grow in the wall of your uterus. They
can cause multiple symptoms like pain, bleeding, infertility, etc
It is possible that the fibroids are extending into the lumen of your uterus. During the time of periods
the bleeding tends to get exaggerated if there are such fibroids. And this is one of the commonest presentations of fibroids in uterus (menorrhagia) also due to increase in blood flow and size of the fibroid , there is also pain during the periods that is increases.
By affecting the deposition and growth of the conceptus in the wall of the uterus, fibroids, especially
of the variety that tends to grow into the cavity of the uterus tend to cause infertility.
The treatment depends on the age of the patient, and whether the fibroid is symptomatic.
If there are no symptom in fibroid, which is often the case It is best left alone , and can be watched.
If a fibroid causes massive bleeding in young women we remove only the fibroid, this procedure is
called myomectomy, as the fibroid is called myoma. This can be done either by keyhole technique or open method. We try to do all the procedure by keyhole technique here at LIMA.
In about 50% of the cases we are able to do it as a day case. But in others they tend to stay for a day
or two. Myomectomy is in some ways a more complicated procedure than a hysterectomy because it involves a higher amount of bleeding and suturing of the cavity.
Actually we tend to remove in one of two ways:
1. Through the back of the vagina we remove some of the fibroid (posterior colopotomy)

2. We use a special instrument called morcellator that breaks up the myoma into several small
fragments and is removed through the keyhole.

Very rarely, that is if the fibroids are all over the uterus or the patient is beyond the age of reproduction or have completed their family, we would recommend the removal of uterus with the fibroids. Obviously the patient is not going to develop anymore complication from that address (the old no headache approach). The main problem with myomectomy is that the myomas can come back in other parts of the uterus. This is something that the patient and the gynaecologist will need to contend with. A hysterectomy obviates this worry.

Myomectomy specialists

Dr. Deepa Ganesh

Advance Laparoscopic Gynecologist, Robotic Surgeon & Cosmetic Gynecologist Surgeon

Dr. Jayalakshmi

Obstetrician and gynaecologist, Infertility specialist and Laparoscopic surgeon