Laparoscopic Myomectomy

Definition - What does Laparoscopic Myomectomy mean?

A laparoscopic myomectomy is a minimally invasive procedure that involves the surgical removal of uterine tumors known as fibroids by means of a laparoscope. It is a preferred choice for women who have certain types of symptomatic fibroids that require treatment but who also wish to retain their uterus and fertility. A laparoscopic myomectomy can increase the odds of a woman getting pregnant.

FertilitySmarts explains Laparoscopic Myomectomy

In a laparoscopic myomectomy, a telescope-like instrument, known as a laparoscope, is inserted through a cut made in the abdominal skin at the navel, and the fibroid is removed. After removal of the fibroid, the surgeon washes the uterine defect thoroughly and controls any bleeding with the help of electric current. The surgeon then sews the uterine muscle and the abdominal skin.

In addition to being minimally invasive, the procedure offers several advantages over the open or abdominal approach, including:

  • Quick recovery
  • Shorter hospital stay
  • Reduced risk of bleeding
  • Reduced risk of formation of pelvic adhesions
  • Improved rates of pregnancy with submucosal fibroids
  • Improvement of symptoms at least temporarily

The procedure is usually done in women who have submucosal fibroids, located beneath the lining of the uterus but in whom the entire uterus cannot be removed because of their desire to conceive in future. A laparoscopic myomectomy can improve the outcomes of IVF as the presence of submucosal fibroids also contributes to the failure of assisted reproduction.

Women who have large-sized, multiple or deeply embedded fibroids are not the ideal candidates for laparoscopic myomectomy (LM) and require abdominal myomectomy or otherwise if they do not desire future childbirth, the entire uterus is removed (hysterectomy).

Risks associated with laparoscopic myomectomy include:

  • Pelvic infection
  • Recurrence: The fibroids can grow back following LM; the rate is as high as 52.9% to 62.1% at 5 years after the procedure.
  • Formation of scar tissue and infertility: Although rare, myomectomy incision can result in the formation of scar tissue in the lining of the uterus, which interferes with the implantation of the embryo in the uterus.
  • Entire removal of the uterus (hysterectomy) may be required if removing the fibroid via myomectomy causes massive bleeding.

Owing to the chances of recurrence, a woman who undergoes myomectomy for fibroids should attempt pregnancy as soon but as safely as possible after a myomectomy.

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