Fibroid Removal (Myomectomy)

A myomectomy is a surgical procedure to remove fibroids from a woman’s uterus. Fibroids are benign growths in the uterus. Based on the location of growth in the uterus, they are categorised into different types.

The exact reason why fibroids form is unknown. They may be caused because of genetics or hormonal imbalances.

Most fibroids do not cause any symptoms and are harmless. However, when the fibroids grow too large, they cause symptoms like:

• Heavy bleeding

• Pain in the abdomen, lower back and pelvis

• Irregular or longer-lasting periods

• Pain or discomfort during sexual intercourse

• Frequent urination or constipation

Fibroids in the uterus can be detected by tests like:

• Pelvic exam

• MRI

• Ultrasound

• Hysteroscopy

The different types of myomectomy are:

• Hysteroscopic myomectomy

• Robotic myomectomy

• Laparoscopic myomectomy

• Abdominal myomectomy

This procedure is applicable only for submucosal fibroids which are in the uterine cavity. The fibroids in the uterine wall cannot be removed through this procedure.

Flow of the procedure:

• Patient is given general anaesthesia for the procedure

• A 1-2 inch incision is made in the vagina

• An instrument called a hysteroscopic resectoscope is passed through the vagina into the uterine cavity

• The fibroids are removed through the vagina

• The incision is taped and the patient is taken to the recovery room

In this procedure, a tiny robot is inserted through an incision in the vagina to remove the fibroids.

Flow of the procedure:

• Patient is given general anaesthesia for the procedure

• 4 small incisions are made in the abdomen

• A tiny robot is inserted through one of the incisions

• The camera footage is visible on a screen that guides the doctor to perform the surgery

• The fibroids are cut into smaller bits and removed through the incisions

• The incisions are taped and the patient is taken to the recovery room

This procedure can be used to remove smaller fibroids. If you have large or several fibroids, this procedure is not advisable.

Flow of the procedure:

• Patient is given general anaesthesia for the procedure

• Several small incisions are made

• Surgical and viewing instruments are inserted into the incisions

• The fibroids are removed through one of the incisions

• The incision is taped and the patient is taken to the recovery room

This is an open surgery in which the fibroids are removed directly from a large incision made in the lower abdomen.

Flow of the procedure:

• Patient is given general anaesthesia for the procedure

• A large incision is made in the abdomen

• The fibroids are removed from the large incision

• The incision is sutured using several stitches and the patient is taken into the recovery room

Abdominal myomectomy is a major surgical procedure. The other procedures are relatively simple procedures which don’t involve complications.

Abdominal myomectomy is a complicated procedure. There is a risk of haemorrhage, anaemia, wound sepsis, pelvic adhesions and uterine rupture in subsequent pregnancies.

You may need about 4 to 6 weeks to fully recover. Do not lift anything heavy while you are recovering so that your incision and your belly muscles can heal.

After myomectomy surgery, most women experience relief of bothersome signs and symptoms, such as excessive menstrual bleeding and pelvic pain and pressure.

Depending on the type of surgery, you can return to work within two to six weeks (abdominal myomectomy takes the longest recovery time)

The swelling will take several weeks to go down. It may take about 4 to 6 weeks to fully recover.