A laparoscopic myomectomy is a surgery to remove uterine fibroids where the surgeon accesses the site through a series of small incisions in the abdomen, rather than a single large incision to expose the uterus. A gynecological surgeon with training in laparoscopic procedures usually performs this procedure. It is done under general anesthesia and is typically performed on an outpatient basis, allowing patients to go home after they wake up and fully recover from the anesthetic drugs. The risks are relatively low, and the healing time is typically short.
Uterine fibroids come in several types. When they are buried deep in the mucus membranes of the uterus, seen in submucus fibroids, they can be difficult to access with a laparoscopic myomectomy. Fibroids on the surface or growing on stalks are good candidates for this surgery. These noncancerous growths in the uterus can cause abnormal uterine bleeding, interfere with fertility, and lead to pain and stress for the patient. Removing them should resolve these symptoms and make the patient feel more comfortable.
In a laparoscopic myomectomy, the patient is put under anesthesia and the surgeon makes several small incisions around the abdomen and pubis. These incisions are used to introduce cameras and surgical tools. Typically, gas is pumped into the abdomen to inflate it, making it easier to see the uterus and other tissue. Using the laparoscopic tools, the surgeon accesses the uterus, removes the fibroid, checks for additional growths, and then removes the tools and closes the incisions.
Time under anesthesia with a laparoscopic myomectomy can be shorter than a traditional open surgery. This reduces risks of blood clots and lung problems after surgery. The use of small incisions allows the patient to heal quickly and reduces aftercare needs; instead of having to manage a large abdominal incision, the patient has a series of small cuts, often manageable with over-the-counter bandage tape.
As with any surgery, there are risks. A patient may have an adverse reaction to anesthesia, or an infection could develop. It is also possible that the surgeon may not be able to reach the fibroids laparoscopically, and it may be necessary to make an open abdominal incision to expose the uterus and successfully remove the growths. When meeting with a surgeon to discuss a laparoscopic myomectomy, patients should ask about risks and the surgeon's record. It is also a good idea to ask where the surgeon trained and how long the surgeon has been practicing.