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A new website for gynaecologists interested in the surgical management of fibroids is now on line. www.fibroidsurgery.org
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.
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
early history of laparoscopic myomectomy
myomectomy was first described by Kurt Semm, Professor
of Obstetrics and Gynaecology in the University of
Kiel, Germany. Semm was one of the pioneers of modern
laparoscopic surgery. He developed a range of miniature
instruments which are still used today. He also introduced
laparoscopic suturing, and it was this innovation which
made it possible to perform major laparoscopic procedures
such as myomectomy safely and effectively.