Myomectomy is a surgical procedure to remove uterine fibroids. The type of myomectomy depends upon the location and number of fibroids.
- Abdominal myomectomy – The abdominal myomectomy requires an abdominal incision, usually of the “bikini” type, and the fibroids are removed through the incision. This abdominal approach is the best choice when fibroids are large, numerous, and or located deep within the muscle of the uterus. This is usually an inpatient procedure requiring a 24-48 hours stay.
- Laparoscopic myomectomy – Fibroids can also be removed by laparoscopy, with a mini incision (less than an inch) near the belly button and along the bikini line. This approach is preferred when fibroids are few in number, superficial in location and small in size. This is usually performed as an outpatient procedure and you return home the same day.
- Hysteroscopic myomectomy – A hysteroscopic myomectomy is recommended when most of the fibroid is located within the cavity of the uterus (submucosal). This vaginal or uterine approach involves no abdominal incisions. A small instrument (hysteroscope) is inserted through the cervix into the uterus and special scissors, laser or electrocautery is used to remove the fibroid. This is usually performed as an outpatient procedure.
- Robotic assisted myomectomy– During a robotic procedure, a telescope is placed into the abdomen at or above the navel. Up to five other small incisions are made to hold the instruments to remove the fibroids. Women are typically sent home from the hospital the same day or within 24 hours. Recovery time is usually between a few days and a week. (Robotic surgery is not offered at TFAFC).
A myomectomy is a safe procedure that results in few serious complications. Postoperative adhesion formation can be a common complication, but good surgical technique combined with adhesion-prevention strategies are routinely used at myomectomy to decrease this possibility.