Laparoscopic Myomectomy / Laparoscopic-Assisted Abdominal Myomectomy
Fibroids are common benign (non-cancerous) tumors that grow from the muscle layers of the uterus. They can grow on the outside, inside, or within the smooth muscle of the uterine wall. Fibroids affect up to 70-80% of women by the age of 50. On average, surgery for fibroids involves as many as 6-7 fibromas.
Fibroids often result in an enlarged uterus and they can vary in size from that of a small bean to as large as a melon. Together, they can be as large as a full term pregnancy! They most commonly cause heavy or abnormal menstrual bleeding, pain and pressure.
Uterine fibroids can be problematic for fertility depending on their location. Fibroids most likely to affect fertility/pregnancy include:
- Submucosal (In the uterine cavity or bulging into the cavity wall): These can cause miscarriage/pregnancy failure secondary to implantation failure. These can be addressed hysteroscopically (through the vagina, no incisions) with resection or with combined approach.
- Intramuscular (in the uterine wall, myometrium): Not always detrimental to early pregnancy, however, they can result in multiple pregnancy complications including malposition of the fetus (e.g. breech position), increased pregnancy pain, preterm delivery, increased blood loss after delivery.
Other common locations include:
- Subserosal (outer uterine layer)
- Pedunculated (attached to the uterus by a pedicle)
- Cervical fibroids, within the lower uterus inside the cervix
Routes of Fertility Preservation Fibroid Surgery
Laparoscopy Myomectomy with or without Robotic Assistance: Minimally invasive way to remove any type of fibroid, but best for intramural and subserosal fibroids.
Laparoscopic-assisted abdominal myomectomy (LAAM procedure): Performed via combined approach laparoscopic and mini open bikini line incision for fibroid removal and multi-layer uterine repair.
Hysteroscopic Myomectomy: Ideal for smaller intracavitary or submucosal fibroids. The fibroids are visualized and removed through the vagina and results in no abdominal scarring. This can usually be performed in a same day surgery center.
*We employ a specialized technique that limits abdominal incisions to 1cm except in the most severe of cases. This decreases postoperative pain, surgical time and risk of postoperative hernia.
At Endofertility, we would customize an approach or combination of approaches to treat fibroids specific to your case and personal goals.