The advantages of laparoscopic/hysteroscopic myomectomy are a shorter hospital stay (one day), reduced recovery time and reduced post-operative pain, smaller incisions, better cosmetic results, and a lower cost.

Risks

While most laparoscopic/hysteroscopic myomectomies proceed without difficulty, sometimes a more conventional incision in the abdomen is necessary to safely complete the surgical procedure. As with any other surgical procedure, there are also risks of bleeding, blood transfusion, infection, anesthetic complications, or injury to other structures such as bowel or bladder. There is also risk of intrauterine scar tissue if the fibroid is in the cavity. Women who later become pregnant may require a Caesarean section for delivery because of weakening of the uterine wall from the myomectomy. Lastly, fibroids may still recur after a myomectomy.

Procedure

Laparoscopic myomectomy takes place under either general anesthesia or regional (epidural) anesthesia. The surgeon makes several half-inch incisions in the abdominal wall to place the laparoscope and other instruments. Then the surgeon removes the fibroids and repairs the uterine wall. Often a surgeon uses a needle or laser to perform a myolysis of the fibroids. This technique allows the surgeon to avoid cutting into the uterus by using either electrical current or laser energy to shrink the fibroids to about half their original size after surgery.

Hysteroscopic myomectomy is performed through the woman's cervical canal and does not involve any abdominal incisions. A device called a resectoscope cuts away the fibroids, or an electrical current "evaporates" the fibroids.

After a laparoscopic or hysteroscopic myomectomy, the patient goes home the same day. Most women are back to normal activities within seven to 10 days.