Laparoscopic myomectomy means the removal of fibroids from the uterus laparoscopically. Fibroids are benign growths arising from the uterine wall and are found in 25-30% of women of reproductive age. Small asymptomatic fibroids mostly do not require removal.
Large fibroids which cause symptoms like excessive bleeding, pain during periods, lump in the abdomen or interfere with conception need removal. Fibroids are removed laparoscopically with the help of 3-4 small 5mm incisions made in the abdomen.
After removal from the uterine wall, a special instrument called a morcellator is used to retrieve the fibroid from the abdomen. The advantage of laparoscopic removal includes faster recovery, shorter hospital stay, minimal scars, and no pain.
Laparoscopic myomectomy is a key hole surgery done by inflating your abdomen with gas and passing a small telescope and fine instruments through small cuts less than 1 cm in size each on your abdomen. The fibroid is then detached and removed.
It is a major surgery, the outcome is better than open myomectomy.
It depends on the size, number ,location of fibroids. On a average it takes between 1-2 hours.
Once the fibroids are removed,those particular fibroids cannot grow back. But fibroids are caused by genetic mutations within the uterine muscle. This process over time can create new fibroids. It varies patient to patient hence difficult to predict.
The post operative pain is much lesser than open myomectomy. Patient usually complaints of a cramping abdominal discomfort, shoulder pain and burning sensation around the surgical incisions. The pain settles down with routine pain killers.
You can start taking liquid diet six hours after surgery and switch over to soft solid diet the next day a normal diet from day two of surgery.
There are risks with any operation,but these are small,the main complications are
Uncommon risks are
Damage to bladder, bowel, ureter ,blood cot in veins or lungs
If you want to plan a pregnancy we usually advise you to wait for 3-6 months after a myomectomy to allow the uterus to heal.
Large fibroids can be removed laparoscopically, but we can decide that only after assessing the patient clinically, in some circumstances if the fibroids are too large and not feasible for laparoscopy, we might have to do an open myomectomy.
The postoperative pain and infection is much lesser than an open myomectomy and the recovery is faster.
You will be discharged the same day after surgery with pain killers. Recovery after surgery varies between individuals. Most women resume work in a week .The body will be using extra energy to build new cells and repair itself and patients may therefore feel tired for few days after surgery.
Fibroids that are close to the surface of uterus or in the wall of uterus are commonly removed through laparoscopy, those inside the endometrial lining of the womb but are big are preferally removed laparoscopically.
The fibroid tissue is cut into smaller pieces to allow removal through smaller incisions. It is done using a devce called a morcellator. The abdomen is thoroughly checked and fibroids pieces are removed completely.