Abdominal myomectomy is the traditional operation for removing fibroids and is done through a laparotomy incision. If there are numerous, large fibroids, it is the only way to remove them as the other techniques are not suitable in such cases. Providing the fibroids are not very large, however, a "bikini" type incision can often be used (see diagram).

Abdominal myomectomy is a major operation. As it is generally done in the more difficult cases, complications are more common than with the other routes of surgery, or indeed with hysterectomy. Hospitalisation and recovery also take longer. Nonetheless, it is a good operation when the other procedures are contra-indicated as it is the most thorough type of myomectomy and yet still allows the uterus to be conserved in most patients.

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