Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
Hampstead
London NW3 2QG, UK

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LATEST NEWS

A new website for gynaecologists interested in the surgical management of fibroids is now on line. www.fibroidsurgery.org

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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The early history of laparoscopic myomectomy

Laparoscopic 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.