Service

Myomectomy

Removal of fibroids without removing the uterus is called myomectomy.

This is a  permanent treatment for fibroids. All fibroids do not need to be removed.  

Book an Appointment

Definition

A myomectomy is a procedure to remove fibroids, and then reconstruct the uterus to function normally and also improve fertility. 

There are few indications to perform myomectomy-

  • Symptomatic Fibroids – Heavy Bleeding or pain during menstrual cycle
  • Pressure symptoms due to size and location of fibroids
  • Large mass in the abdomen
  • Infertility due to fibroids
  • Rapidly growing in size
  • There may be a doubt of developing cancer in fibroid

Women who undergo myomectomy have improvement in symptoms, including heavy menstrual bleeding and pelvic pain. Fibroids that are responsible for infertility, in these women removal of fibroids increases the chance of spontaneous conception.

Surgical techniques for myomectomy

Abdominal myomectomy- this is an open operation and is performed via a large abdominal incision. This surgery is rarely done in todays surgical practice as the recovery is slow. The post operative adhesions are also more.

At our unit @ Max Hosiptal Mohali, we offer minimally invasive myomectomy no matter what the size or number of fibroids are present.

  1. Laparoscopic myomectomy– Surgery is done via small incisions in the abdomen The fibroid is then removed through one of these incisions.
  2. Robotic myomectomy– This procedure is similar to a traditional laparoscopy; however due to use of 3D high-definition vision and human wrist like instruments, surgery is done with better precision and control. This reduces blood loss and significantly improves the uterine reconstruction after the removal of the fibroids.
  3. Hysteroscopic myomectomy– If the fibroid is projecting into the cavity, it can removed by using a hysteroscope. This is inserted into the uterine cavity through the vagina and the fibroid is removed using electrosurgery. This procedure does not involve any incision and is done as day care surgery. There is no cut needed in the abdomen.

The most critical part of myomectomy is uterine reconstruction of the uterus for future reproduction. The defects so created in the wall of uterus should be repaired in multiple layers. Additionally one must take care to prevent post operative bleeding and infection. If this step is not done well, the uterus may rupture during a subsequent pregnancy or delivery. The repair done with the use of robotic instruments enables the surgeon to repair the uterus properly as well as minimises the blood loss. The need for conversion to open surgery during the procedure is very low.