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Laparoscopic Fibroid Removal

Fibroids are small growths in the uterus. Since most fibroids are not cancerous, removing them surgically is based on several factors. You may require a laparoscopic fibroid removal if you have the following:

  • Heavy menstrual bleeding
  • Bleeding between periods
  • Frequent urination
  • Pain or pressure in lower abdomen 
  • Difficulty emptying your bladder
  • If you are having difficulty getting pregnant (some fibroids increase the risk of miscarriage or pregnancy complications)

Alternate name

Laparoscopic myomectomy

Body location

The uterus lies in the pelvic region of the female body.

 

How is it performed?

A laparoscopic myomectomy is performed under general anaesthesia. During the surgery, the surgeon will make small incisions (about half an inch long) in the lower abdomen, typically near the belly button.

The surgeon will pass a tube through one of the incisions to fill the abdomen with carbon dioxide gas, allowing them to see all organs clearly. Through another incision, a laparoscope is inserted. A laparoscope is a thin tube with a light bulb and a camera on its tip. Through a third incision, the surgeon inserts the surgical instruments required to remove the fibroids. After removing the fibroids, the surgeon removes all the instruments, releases the gas from the abdomen and closes the incisions.

Preparation for the procedure 

If you are set to undergo laparoscopic fibroid removal, a few things you will need to do in the preparatory phase are:

  • Routine blood tests: You will require a standard blood test before surgery. Your doctor may also perform routine transvaginal sonography to study the uterine lining.
  • Fasting: Stop eating and drinking fluids at least 10 to 12 hours before the surgery
  • Discontinue medications: If you take any medications, your doctor may review them and ask you to stop them before surgery. This is particularly common with blood thinners.
  • Hospital stay: Though your fibroid removal occurs laparoscopically, you will be required to stay in the hospital for at least two or three days.

Procedure type

Surgical procedure

Follow up 

After your surgery, you will be required to stay at the hospital until your surgeon feels you are fit to go home. Painkillers and antibiotics will be prescribed to enable comfortable healing. Your doctor will inform you how to take care of your incision wound and what kind of diet to follow. You may notice vaginal bleeding and spotting for a few days after your procedure. 

You will be required to visit your surgeon for follow-up visits, during which they will evaluate your overall health and healing. If you plan to conceive, your doctor will inform you about the next steps.

Risks

Though laparoscopic fibroid removal surgery is common and safe, it does carry a few risks. Some of the risks associated with this procedure include the following:

Excessive bleeding: Women with a larger uterus or excessive fibroids are at risk of developing heavy menstrual bleeding, resulting in low blood count and anaemia.

Risk during pregnancy: Women who had a deep incision in the uterus during laparoscopic fibroid removal may be advised to get a caesarean delivery.

Hysterectomy: If the surgeon finds other uterine abnormalities along with fibroids, they may decide to remove the entire uterus.

Adhesions: Scarring and adhesions are common after fibroid removal. When adhesions form inside the uterus, there are chances of light menstrual periods and difficulty in getting pregnant. The risk of adhesions is higher in the case of  open fibroid removal.

Recovery

The recovery time after laparoscopic fibroid removal is shorter and more comfortable than conventional open surgery. Your doctor will prescribe a few medications to help relieve your pain. You must avoid lifting anything heavy or participating in intense exercise or activity until your incision is fully healed. You may be required to wait at least six to eight weeks before having sex. Women who plan to conceive after surgery must wait at least three to six months to allow complete healing of the uterus. The first few weeks after your surgery are meant for complete rest. You will be allowed to take short, light walks that increase circulation to the uterus and accelerate healing.

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