Myomectomy—Laparoscopic Surgery
(Fibroid Tumor Removal; Uterine Fibroid Removal)
Definition
Myomectomy is the removal of fibroids from the wall of the uterus (womb). Fibroids are noncancerous tumors in the muscle of the uterus. Laparoscopic surgery uses small incisions and tools to remove the fibroids.
Reasons for Procedure
This procedure is done to relieve problems caused by fibroids without doing a hysterectomy (removal of the uterus). These problems can are:
- Pelvic pain
- Back pain
- Pressure on the bladder
- Abnormal vaginal bleeding
- Heavy periods
- Difficulty becoming pregnant
- Discomfort during sex
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Recurrence of fibroids
- Damage to other organs
- Severe scarring, resulting in pain, bowel blockage, or infertility
- Uterine wall weakness
- Need for special care in pregnancy, such as the need to deliver by cesarean section
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as images of the pelvic organs
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
A small incision will be made in the navel. A tube with a camera will be inserted into the abdomen through the cut. It will be used to examine the abdomen. Two or three more incisions will be made in the abdomen. Other tools will be inserted through these incisions. Each fibroid will be located and removed. The incisions will be closed with stitches. Bandages will be placed over them.
The doctor may need to switch to open surgery if the procedure cannot be done laparoscopically. During an open surgery, a larger incision will be made in the abdomen to do the surgery.
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How Long Will It Take?
1 to 2 hours
Will It Hurt?
Pain, vaginal discharge, and bleeding are common in the first few days. Medicine and home care can help.
Average Hospital Stay
Most people can go home the next day. If there are any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
Right after the procedure, the staff may:
- Give you pain medicine
- Encourage you to walk
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
It will take about 2 to 4 weeks to fully heal. Physical activity will be limited during this time. Sex will need to be avoided. Ask for help with daily activities and delay your return to work.
Call Your Doctor
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excessive bleeding, or discharge from the incisions
- Pain that you cannot control with the medicine you have been given
- Vaginal bleeding that soaks more than one pad per hour
- Foul smelling vaginal discharge
- Swelling, redness, or pain in the legs
- Pain, burning, urgency or frequency of urination, or lasting blood in the urine
- New or worsening symptoms
If you think you are having an emergency, call for medical help right away.
RESOURCES:
American Congress of Obstetricians and Gynecologists
http://www.acog.org
Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
Women's Health Matters
http://www.womenshealthmatters.ca
REFERENCES:
Uterine fibroids. Society of Cardiovascular and Interventional Radiology website. Available at: https://www.sirweb.org/patient-center/conditions-and-treatments/uterine-fibroids. Accessed August 25, 2021.
Uterine leiomyoma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/uterine-leiomyoma. Accessed August 25, 2021.
Last reviewed July 2021 by EBSCO Medical Review BoardBeverly Siegal, MD, FACOG Last Updated: 8/25/2021