Laparoscopic Myomectomy
What you need to know?

Dr. Deepak Goenka
IVF SPECIALIST

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Fibroids are benign tumour mostly seen arising from the uterus. They are seen in about 25–50% of women of all age groups. Most of the fibroids remain silent without causing any problem. But if a fibroid starts creating
problems like excessive bleeding, urinary or bowel symptoms, pain or infertility, then these fibroids require interventions or treatment. They can be handled temporarily by medications but a permanent solution requires surgery.

Earlier when pregnancy was no longer desired, removal of uterus (Hysterectomy) was a common choice. But lately, as science has progressed, we have started to understand the long term problems associated with hysterectomy. As a result removal of only troublesome tumour (Myomectomy) is now a days preferred choice by most of the surgeons and
patients.

Myomectomy can be performed either by

• open surgery (Laparotomy); or by
• Keyhole surgery (Laparoscopy).

Laparoscopic Myomectomy is always the first choice when we want to remove the fibroid only. When we compare laparoscopy procedure with open myomectomy (Laparotomy), we have many advantages.

• The laparoscopy procedure is associated with less blood loss, less pain, fewer chances of infection, a shorter period of hospitalization (1-2 days only) and less chances of hernia in the future.
• The patient can walk within 24 hrs and restart daily duties within a week.
• The chances of complications during pregnancy such as rupture uterus are the same by both the routes.
• The initial operative expenses of laparoscopic myomectomy are usually more than open surgery. But when compared with open surgery (which needs usually 6-8 weeks of rest) the overall cost is much less. This is because the patient (and/or) her husband or attendant can resume their daily
  household, office, and other duties with 7-10 days, not doing which hampers their day to day life as well as their source of income.

Therefore Laparoscopic Myomectomy should be the preferred choice for the removal of myoma, until and unless there is some contraindication for laparoscopy.

At IHR we are performing laparoscopic myomectomy since the Year 2000 (now almost 20 years). We have performed so far more than a thousand myomectomies either laparoscopically or through hysteroscopy. The size of myoma that we have removed varies from very small myoma disturbing
the endometrium to as big as 28 weeks size.