Laparoscopic Myomectomy

Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).

Laparoscopic and robotic surgery use smaller incisions than a myomectomy, or laparotomy, does. This means you may have less pain, lose less blood and return to normal activities more quickly than with a laparotomy.

Hysteroscopic myomectomy

To treat fibroids that bulge significantly into your uterine cavity (submucosal fibroids), your surgeon may suggest a hysteroscopic myomectomy. Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus.

A hysteroscopic myomectomy generally follows this process:

• Your surgeon inserts a small, lighted instrument — called a resectoscope because it cuts (resects) tissue using electricity or a laser beam — through your vagina and cervix and into your uterus.
• A clear liquid, usually a sterile salt solution, is inserted into your uterus to expand your uterine cavity and allow examination of the uterine walls.
• Using the resectoscope, your surgeon shaves pieces from the fibroid until it aligns with the surface of your uterine cavity. The removed fibroid tissue washes out with the clear liquid that's used to expand your uterus during the procedure.

Rarely, your surgeon may use a laparoscope inserted through a small incision in your abdomen to view the pelvic organs and monitor the outside of the uterus during a complicated hysteroscopic myomectomy.

After the procedure

At discharge from the hospital, your doctor prescribes oral pain medication, tells you how to care for yourself, and discusses restrictions on your diet and activities. You can expect some vaginal spotting or staining for a few days up to six weeks, depending on the type of procedure you've had.