Laparoscopic Myomectomy

The uterus is a muscular organ located in the pelvic cavity. It has three main layers:

• Endometrium: The inner lining of the uterus, which thickens during the menstrual cycle and supports embryo implantation during pregnancy.
• Myometrium: The muscular layer of the uterus, which is the most common site for fibroid development.
• Perimetrium: The outer layer of the uterus, providing support and protection for the organ.

Fibroids (myomas) are benign tumors that develop within the myometrium. Their size can range from a few millimeters to several centimeters, and they may grow toward the inside or outside of the uterus. Fibroid growth is influenced by estrogen and progesterone levels; particularly when estrogen levels are high, fibroids may grow more rapidly.

Types of Fibroids

• Submucosal: Grow into the uterine cavity, can increase menstrual bleeding, and may cause infertility.
• Intramural: Located within the uterine wall, often causing pain and a sense of pressure.
• Subserosal: Grow outward from the uterus, creating fullness and pressure in the pelvis.
• Pedunculated: Fibroids attached by a stalk, which can rarely twist and cause sudden pain.

The location, size, and number of fibroids are critical in determining a patient’s symptoms and the appropriate treatment method.

Laparoscopic myomectomy is particularly preferred in the following situations:

• Pain: Pelvic or abdominal pain caused by fibroids.
• Excessive bleeding: Menstrual bleeding that is prolonged and heavy.
• Infertility: Fibroids that interfere with pregnancy or increase the risk of miscarriage.
• Urinary issues: Frequent urination, urinary incontinence, or difficulty urinating.
• Other symptoms: Constipation, a feeling of pressure in the abdomen, or pain during sexual intercourse.

The decision to perform surgery is made individually for each patient, taking into account the number, size, and location of the fibroids as well as the patient’s overall health condition.

Accurate diagnosis of fibroids is critical for determining the appropriate treatment plan.

• Ultrasonography: Abdominal or transvaginal ultrasound is used to determine the size and location of fibroids.
• Magnetic Resonance Imaging (MRI): Provides detailed anatomical imaging of fibroids.
• Hysteroscopy: Used to evaluate fibroids within the uterine cavity.
• Doppler Ultrasound: Suitable for examining the vascular structure and blood flow of fibroids.

Laparoscopic myomectomy offers numerous benefits for patients:

• Minimal Invasive: Performed through small incisions, minimizing tissue damage.
• Rapid Recovery: Patients can generally return to daily activities in a short time.
• Less Pain: Lower pain and bleeding risk compared to open surgery.
• Safe: When performed by experienced surgeons, the risk of complications is low.
• Increases Pregnancy Chances: Removal of fibroids reduces infertility risk and enhances the likelihood of conception.

• Anesthesia: General anesthesia is administered during the procedure, ensuring the patient feels no pain.
• Insertion of the Laparoscope: Several small incisions are made in the abdominal area. The laparoscope and surgical instruments are inserted through these incisions.
• Removal of Fibroids: Using the laparoscope, the surgeon locates the fibroids and removes them with specialized instruments. Large fibroids may be fragmented and removed (morcellation).
• Completion of the Procedure: After the fibroids are removed, the instruments are withdrawn, the incisions are closed, and sterile dressings are applied.

• Bleeding: Mild bleeding may occur after surgery.
• Infection: Rarely, an infection may develop at the surgical site.
• Uterine Rupture: Requires caution in women planning future pregnancies.
• Infertility: In rare cases, fertility issues may arise after surgery.
• Recurrence of Fibroids: Regular ultrasound follow-up is recommended.

What is the difference between laparoscopic myomectomy and open surgery?
Due to minimal incisions, laparoscopic myomectomy results in less pain, shorter recovery time, and better cosmetic outcomes.

When can I return to daily activities after surgery?
Patients can generally resume normal activities within 1–2 weeks.

Do fibroids recur?
Fibroids may recur after surgery; regular ultrasound follow-up is recommended.

Does the surgery increase the chance of pregnancy?
Removing fibroids reduces infertility risk and can improve the chances of pregnancy.

For detailed information about laparoscopic myomectomy and to determine the most suitable treatment plan for you, reach out to A Life Health Group. Our expert team is ready to provide safe and effective care in the field of women’s health.