A laparoscopic myomectomy is a minimally invasive surgery to remove uterine fibroids (non-cancerous growths) while preserving the uterus. It uses small abdominal incisions, a thin camera (laparoscope), and specialized tools. This approach offers less scarring, less pain, and a faster recovery compared to open abdominal surgery.
This procedure is suitable for women who wish to retain fertility or avoid hysterectomy. Fibroids may though recur, as this procedure does not prevent new fibroids from forming.
Why is it Performed?
Your gynaecologist may recommend this surgery if you have:
- Symptomatic fibroids causing heavy menstrual bleeding, pelvic pain, or pressure.
- Infertility or pregnancy complications linked to fibroid size/location.
- Fibroids that are not suitable for less invasive treatments (e.g., hysteroscopic resection).
Before Surgery
- Pre-operative tests:
Pelvic ultrasound/MRI to map fibroids.
Blood tests (check for anaemia or infections). - Preparation:
Fasting: No food/drink for 6–12 hours before surgery.
Bowel prep: Rarely required (your doctor will advise).
Medications: Adjust blood thinners (e.g., aspirin) as instructed. - Arrange support: Plan for someone to drive you home and assist for 1–3 days.
During the Procedure
- Anaesthesia: General anaesthesia (you’ll be asleep).
- Incisions:
- 3–4 small cuts (0.5–1 cm) in the abdomen.
- Carbon dioxide gas inflates the abdomen for visibility.
- Surgery:
- The laparoscope guides the surgeon to locate and remove fibroids. Fibroids are cut into small pieces (morcellation) and removed through the incisions or vagina.
- Closure: Stitches/glue close the incisions.
- Duration: 1–3 hours (depends on fibroid size/number).
Risks and Complications
- Common (temporary):
- Shoulder/neck pain (from gas irritation).
- Mild bloating, bruising, or vaginal spotting.
- Rare but serious:
Infection, bleeding, or damage to nearby organs (bladder, bowel).
Blood clots (deep vein thrombosis).
Conversion to open surgery (larger incision) if complications arise.
Recovery
In the hospital:
- Most patients go home the same day or after a 1-night stay.
- Pain relief and anti-nausea medications are provided.
At home:
- Rest: Avoid heavy lifting (>5kg), exercise, or driving for 2–4 weeks.
- Pain management: Use prescribed medications or over-the-counter options (e.g., paracetamol).
- Wound care: Keep incisions clean/dry; watch for redness/swelling.
- Activity:
- Gentle walks to aid recovery and prevent clots.
- Gradually resume normal tasks over 1–2 weeks.
- Return to work: Typically, 1–2 weeks (adjust based on job demands).
Long-Term Effects
- Fertility: Many women conceive after recovery (wait 3–6 months as advised).
- Pregnancy risks: Slightly increased risk of caesarean delivery due to uterine scarring.
- Fibroid recurrence: Regular annual monitoring via ultrasound may be recommended.
eGynaecologist Advice
- You should consider annual check-up for fibroids if you are diagnosed with fibroids in uterus and take preventive actions in consultation with your gynaecologist to avoid long-term consequences.
- You should seek gynaecological help if you have severe pain, fever, or chills after myomectomy procedure or notice heavy bleeding or foul-smelling discharge from incisions
- You must seek urgent gynaecological review if you develop chest pain, shortness of breath, or calf swelling after while you are recovering from surgical procedure
Frequently Asked Questions
Will I have scars?
Incisions heal into small, faint marks (usually less visible than open surgery scars).
How soon can I try to conceive?
Discuss timing with your doctor – typically after 3–6 months of healing.
Can fibroids grow back?
Yes, but not all regrowth causes symptoms.
Is recovery faster than abdominal myomectomy?
Yes – most resume normal activities within weeks vs. months.
