Laparoscopic myomectomy is a minimally invasive surgery to remove uterine fibroids using small incisions and a camera-equipped instrument, preserving fertility by removing fibroids while leaving the uterus intact. The procedure involves creating small abdominal ports for instruments and a laparoscope to view the uterus on a monitor, where the surgeon then dissects and removes the fibroid before closing the uterine incision with sutures. This technique offers faster recovery and a shorter hospital stay compared to open surgery, though it requires advanced surgical skill for intracorporeal suturing and complex fibroid removal.
1 The Procedure Step-by-Step
1. Incisions
Small incisions are made in the abdomen to insert specialized laparoscopic instruments.
2. Visualization
A laparoscope, a thin tube with a high-definition camera and light, is inserted through one of the incisions to provide a magnified view of the fibroid on a video monitor.
3. Fibroid Removal
Using specialized instruments inserted through the ports, the surgeon carefully makes an incision into the uterus, dissects the fibroid from the surrounding tissue, and removes it.
4. Suturing
The uterine incision is then closed in layers using sutures to facilitate proper healing and restore uterine wall integrity.
5. Specimen Extraction
The fibroid is carefully removed from the abdomen through one of the small laparoscopic incisions.
2 Advantages of Laparoscopic Myomectomy
- Minimally Invasive: Smaller incisions result in significantly less post-operative pain and tissue trauma.
- Faster Recovery: Patients typically recover more quickly and can return to normal daily activities sooner than with open abdominal surgery.
- Shorter Hospital Stay: Patients may only need to stay in the hospital for 24–48 hours.
- Fertility Preservation: It is an excellent option for women who want to have children in the future because it removes fibroids while preserving the uterus.
3 Clinical Considerations
- Advanced Skills Required: This is a technically demanding procedure that requires advanced laparoscopic suturing skills.
- Fibroid Characteristics: It is generally suitable for patients with a limited number of fibroids and is particularly useful for larger fibroids that are difficult to remove via other methods.