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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.
PROS
Small external scars
Complications not that common
Relatively short hospital stay
Recovery in a few weeks
Less risk of adhesions (scar tissue) than with laparotomy
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CONS
Only suitable for a few small to medium
sized fibroids which are situated mostly
on the outside of the uterus |
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