Laparoscopic myomectomy

Laparoscopic myomectomy is also done using a narrow telescope and miniature instruments, but these are inserted into the body through the abdomen (stomach). Typically, for instance, the laparoscope is placed in the umbilicus (belly button) and the other instruments are put lower down (see diagram). This type of operation is used when the fibroids are on the outside of the uterus, provided there are not too many of them and they are not too large. The fibroids are excised using instruments such as scissors, grasping forceps, and diathermy or laser. The uterus is then usually repaired with sutures (stitches), and the fibroids removed either through one of the small abdominal incisions following morcellation (cutting into small pieces) or via the vagina.

Laparoscopic myomectomy is a more difficult procedure than hysteroscopic myomectomy, and takes longer. Bleeding can be more of a problem, so the chance of requiring a blood transfusion is greater. Hospital stay is typically 3 to 4 days, and recovery a few weeks.

	Small abdominal scars Shorter hospital stay than open myomectomy Relatively quick recovery
	Only suitable for small/few fibroids Fibroids should not be inside the uterine cavity

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