The surgical removal of fibroid tumors or myomas from the uterus is called myomectomy. It can be done in different ways such as hysteroscopy open myomectomy, open myomectomy or laparoscopic myomectomy.
Laparoscopic myomectomy – is an advance laparoscopic procedure in which several large fibroids less than 10 cm can be removed by using laparoscope depending on patient’s condition. This surgical procedure is performed as out-patient surgery under the influence of general anesthesia. There are several advantages of laparoscopic myomectomy over open abdominal
surgery that include:
• Less scarring or cosmetically improved scar
• Small incisions
• Less pain post surgery
• Short hospital stay
• Faster recovery
• Early return to normal activities
Doctor will perform some tests such as clinical examination, medical history of the patient, assessment of symptoms, ultrasound scan or MRI in case adenomyosis is suspected. Patient will be given some hormonal injections or tablets such as GnRH as a monthly or three monthly to shrink the larger fibroids that can be removed easily through laparoscopic surgery. This medication therapy also helps in reducing the blood loss during the surgery and may stop the periods allowing hemoglobin to build up.
During the surgery, patient will be given general anesthesia. Surgeon will insert the laparoscope through the navel to see inside the pelvic and abdominal organs. Few small incisions will be made below the pubic area and surgical instruments are placed through these incisions to remove the fibroids from the uterine muscle. Surgeon uses a special device known as morcellator to cut the fibroid into smaller pieces which are then extracted out through smaller incision. After removing the fibroids wounds will be closed with sutures. This is a safe and very effective procedure when performed correctly by a highly trained and skilled physician.
Patient may require staying in the hospital for 24 to 48 hours depending on the health condition. Patient may feel some shoulder pain or may have light vaginal bleeding after the surgery for which doctor will prescribe some medicines to manage post operative pain. Proper rest and plenty of fluids are recommended. Patient should gradually start taking short walks, shower as normal and should avoid lifting heavy objects.
Laparoscopic myomectomy is less invasive surgery but still involve some risk and complications such as:
• Excessive bleeding
• Injury to bowel , bladder or uterus
• Deep venous thrombosis
• Pulmonary embolus
• Post operative pain