Laparoscopic myomectomy is a surgical procedure that is carried out to remove fibroids from the uterus. Fibroids are tumors which arise around the muscle of the uterus and form masses. The treatment for removing fibroids is known as myomectomy. Laparoscopic myomectomy can be performed on fibroids that are less than 5 and less than 18 weeks in size. Pedunculated myomas or fibroids that are attached to the outside of the uterus by a stalk are the easiest to remove laparoscopically. Subserous myomas or fibroids that are close to the outer surface can be removed by laparoscopic myomectomy as well. Submucous fibroids or fibroids that are deep in the uterine wall are the most difficult to remove by laparoscopic myomectomy.
Let us know take a look at what laparoscopic myomectomy surgery involves. Such a surgery is usually performed as an outpatient procedure under general anesthesia. Laparoscopic myomectomy procedure involves using a small scissors like instrument to open the thin covering of the uterus. This instrument, after locating the fibroid under the opening, grasps it and then frees it from its attachment to the uterine muscle. After this, the fibroid is cut into small pieces with the help of an instrument called a morcellator. Each piece is then removed through the small incisions. Once this is done, the openings in the uterus are sutured with the help of specially designed laparoscopic grasping instruments and suture holders. A laparoscopic myomectomy can take anywhere between one to three hours. The duration of the procedure depends on the position, size and number of fibroids present in the uterus.
Laparoscopic myomectomy recovery time is much faster than that of an ordinary surgery where the abdomen is cut. This is one of the main advantages of laparoscopic surgery. Most women can leave the hospital the same day as surgery. If there has been more extensive surgery, patients are advised at least a one day stay in the hospital. There is usually minimal discomfort associated with this kind of surgery as the incisions are small. Women can usually walk on the day of the surgery, drive in about a week’s time and return to normal exercise and activity within two weeks.
Laparoscopic myomectomy complications includes (in some cases) excessive blood loss, the need to convert to a laparotomy. Other complications are the same as for laparoscopic surgery in general - urinary retention, infection, injury to organs, hematoma, and reactions to anesthesia and so on.
Laparoscopic myomectomy cost is higher due to the need for specialized instruments as well the need for more theatre staff and theatre set up.