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.
Key Facts:
- Suitable for women who wish to retain fertility or avoid hysterectomy.
- Fibroids may 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.
- The uterus is repaired with dissolvable stitches.
- 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.
- Fibroid recurrence (15–30% of cases).
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 monitoring via ultrasound may be recommended.
Frequently Asked Questions
Q: Will I have scars?
A: Incisions heal into small, faint marks (usually less visible than open surgery scars).
Q: How soon can I try to conceive?
A: Discuss timing with your doctor – typically after 3–6 months of healing.
Q: Can fibroids grow back?
A: Yes, but not all regrowth causes symptoms.
Q: Is recovery faster than abdominal myomectomy?
A: Yes – most resume normal activities within weeks vs. months.
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
