Laparoscopic Myomectomy is a minimally invasive surgical procedure designed to remove fibroids from the uterus without causing damage to the organ. It is sometimes referred to as Robotic Myomectomy in medical contexts.
This surgery is typically recommended when fibroids cause significant issues such as pelvic pain, frequent urination, irregular bleeding, or heavy periods. The procedure involves removing fibroids through small abdominal incisions, with several techniques available depending on the fibroids' location and size.
Preparation | Procedure | Types | Symptoms | Risks & Complications | Recovery | What to Expect | Cost
How Do You Prepare for Surgery?
Mentally prepare for the changes the surgery will bring. Speak with loved ones or seek professional support if needed.
Follow these guidelines before your surgery:
• Avoid wearing jewelry.
• Opt for loose-fitting clothes.
• Do not eat, drink (even water), or smoke after midnight before the surgery.
• Refrain from wearing nail polish.
• Wear low-heeled shoes as you may feel drowsy from the anesthesia.
What Happens During the Procedure?
During laparoscopic myomectomy, your surgeon will make four small incisions (about ½ inch) in your lower abdomen under general anesthesia. Your abdomen will be inflated with carbon dioxide to provide visibility.
A laparoscope, a thin tube with a light and camera, will be inserted through one incision. Small surgical instruments will be inserted through the other incisions. In robotic surgery, a robotic arm will control these instruments.
If the fibroids are small, they may be cut into pieces for removal. Larger fibroids might require a larger incision for an abdominal myomectomy. After removing the fibroids, the instruments will be taken out, carbon dioxide gas will be released, and the incisions will be closed.
Several myomectomy techniques are available, each suited to the location and size of the fibroids. These procedures are performed under anesthesia in an operating room.
Laparoscopically-Assisted Myomectomy: This technique is used for fibroids that extend into the uterine wall or are exposed outside the uterine cavity. A laparoscope and other instruments are inserted into the abdomen to remove the fibroids.
Robotic-Assisted Laparoscopic Myomectomy: Similar to laparoscopic myomectomy, this technique uses robotic assistance to enhance precision and control during the procedure.
Open Abdominal Myomectomy: For large fibroids, surgeons make a vertical incision into the abdomen to gain direct access to the uterus. This method involves a larger incision compared to other techniques and requires more time to heal.
If you experience any of the following symptoms, you might require a laparoscopic myomectomy. Before proceeding with the surgery, your doctor will perform several tests:
• Constipation
• Unusually heavy periods
• Pelvic pain
• Difficulty urinating
• Frequent urination
• Menstrual periods lasting longer than one week
• Pain in the legs and lower back
While laparoscopic myomectomy is generally safe, it carries some risks:
Complications:
• Pregnancy-related issues
• Bleeding
• Fertility problems
• Damage to abdominal organs
• Urinary or bowel problems
Types of Complications:
Intraoperative Complications:
• Enucleation issues
• Hemostasis problems
• Morcellation injury
Postoperative Complications:
• Pelvic adhesion
• Hematoma
Post-surgery, some discomfort and spotting are common and can last for a few weeks. Your doctor will prescribe medications to help manage pain and any bleeding. Recovery times can vary based on the type of surgery:
• Hysteroscopic Myomectomy: Typically requires 2 to 3 days for recovery.
• Abdominal Myomectomy: Usually involves a recovery period of 4 to 6 weeks.
• Laparoscopic Myomectomy: Generally needs 2 to 4 weeks for healing.
To ensure a smooth recovery:
• Rest: Give your body adequate rest and avoid strenuous activities.
• Exercise: Refrain from heavy lifting, intense exercise, and fast walking until you get the green light from your doctor.
• Diet: Maintain a balanced diet to support healing. Stay hydrated and consume fiber-rich foods to prevent constipation.
• Follow-Up: Attend all scheduled follow-up appointments with your healthcare provider to monitor your recovery progress.
• Sexual Activity: Consult your doctor before resuming sexual activities to ensure proper healing.
• Pregnancy Plans: If you plan to conceive, discuss it with your healthcare provider to understand the best time to start trying for pregnancy.
Your recovery experience will be unique, so adhere to your doctor’s personalized advice and recommendations for the best outcomes.
Recovery typically takes 6 to 8 weeks, during which you may experience significant fatigue. Rest is crucial, and heavy lifting should be avoided.
Following the surgery, if your ovaries were removed, you will enter menopause immediately, even if you hadn't reached it naturally. This may result in symptoms like hot flashes, vaginal dryness, and night sweats.
Post-surgery fatigue is common and can last up to 10 weeks, though it may sometimes extend to six months.
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