A laparoscopic myomectomy is a minimally invasive method of removing uterine fibroids through small cuts on the abdomen measuring about 5 to 10mm, with the use of special laparoscopic instruments.
This procedure is done when the fibroids are attached to the outside of the uterus (subserosal), or located wholly or partially within the wall of the uterus (intramural). The fibroids must also be small in size (less than 5cm), and few in number. Laparoscopic myomectomy is not appropriate when the fibroids are completely inside the uterus.
Sometimes, you may be placed on some medications for a few months before the surgery to shrink the fibroids, in order for you to be suitable for a laparoscopic myomectomy.
Before the surgery, some tests will be done to check your blood level, heart and kidney functions, blood group, and blood clotting function. If an abnormality is detected or if you have been known to have a previous illness, you might need to be seen by another doctor to be cleared for surgery. If your blood level is low, you will be placed some tablets or injections to raise the blood level, or to prevent you from having another period, so that your blood level doesn’t drop. Once everything is satisfactory, a date can be fixed.
A laparoscopic myomectomy can only be done under general anaesthesia.
Thin, rodlike instruments are passed through small skin cuts into the abdomen. They are attached to a camera and the images are projected on a screen, so the surgeon is able manipulate them to remove the fibroids under direct visualization. A special gas is first introduced into the abdominal cavity, to create space and improve the surgeon’s view. After removal, the uterus is repaired and the fibroids are cut into small pieces and taken out, the gas is then removed before the skin is closed up.
It takes an average of two to four hours for a laparoscopic myomectomy. There is less pain and abdominal discomfort after surgery, and the risk of bleeding and formation of scar tissue between the uterus and abdominal structures is also reduced.
After the procedure, you will be on admission for a day or two, with very few people requiring to stay in for up to four days. There is not so much pain and bleeding experienced after a laparoscopic myomectomy.
Recovery from this surgery usually takes about two to four weeks before resumption of regular activities. If you intend to get pregnant, you will be asked to wait for about three months before you start trying again, in order to enable the uterus heal completely.