Removal of fibroids - MYOMECTOMY

Myomectomy is a surgical procedure to remove the fibroids, without removing the uterus. Depending on the size and location of the fibroids, they can be removed in different ways, as described below. While open surgery is the most common form of myomectomy done by gynaecologists in Australia, because of our expertise in minimally invasive surgery, we have replaced this with laparoscopic or hysteroscopic myomectomy for most of our patients.

Know more about fibroids and treatment options

1. Hysteroscopic Myomectomy
It is also known as hysteroscopic resection of fibroid. It is suitable for fibroids that occur on the inside (cavity) of the uterus. These fibroids are removed using a fine, slender instrument called hysteroscope. Operative hysteroscopy is a form of endoscopic surgery performed by minimally invasive surgeons.

2. Open Abdominal Myomectomy
This is the conventional way of removing fibroids from the abdomen – and it is the most common route of myomectomy performed by gynaecologists in Australia and New Zealand. The fibroid is removed via a large incision on the abdominal skin (laparotomy). The incision can be horizontal (a bikini line incision) or vertical from just below the navel to pubic bone. Complete recovery typically takes 4-6 weeks.

3. Our specialized procedure - Laparoscopic (keyhole) Myomectomy
Instead of a large bikini line incision, our minimally invasive surgeon makes only small incisions (typically 0.5 – 1.5cm) on the abdomen and uses laparoscopic instruments to remove the fibroid.

Compared to open myomectomy, minimally invasive surgery gives the advantages of less pain, infection, and scarring, as well as quicker return to normal activities.

Know more about laparoscopic surgery

As laparoscopic myomectomy for a big fibroid is considered as a technically challenging procedure, it is only offered by surgeons equipped with advanced laparoscopic skills. In particular, the surgeon have to repair the uterus confidently with precise surgical sutures using laparoscopic techniques. If the fibroid is exceptionally large or deeply embedded in the uterus, it may not be feasible to be removed laparoscopically.

Special concerns of myomectomy

Myomectomy is an effective way to remove fibroids and it brings good outcomes in treating fibroid-related problems. However, there are some special concerns that a woman need to consider when deciding on myomectomy.

• Bleeding during the operation - The risk is especially higher if there are multiple fibroids to be removed. There are blood vessels connecting the fibroids and the uterus tissue. Separating a fibroid from the attached tissue can often cause more bleeding than a hysterectomy (see below).
• Eventual re-growth of fibroids - The younger the patient, the higher a chance that other fibroids may grow from the uterus again before reaching menopause.
• Special precaution in pregnancy – Doctor may advise the woman to have Caesarean section delivery for pregnancies in the future. This is because of the risk of rupture of the myomectomy scar on the uterus when the woman goes into labour.

Because of these concerns, if the woman no longer plan to get pregnant in the future, hysterectomy will offer a permanent solution and definitive cure to her fibroid problems.

Know more about hysterectomy

Each woman is individual and her situation requires an individual plan of management. If you are considering a surgery to treat your fibroid-related problems, please contact us to arrange a personal consultation. Our doctor will discuss your treatment options and help you make the right choice.