What will happen when I choose myomectomy?

When you and your doctor have decided that myomectomy is the right procedure for you, there are still choices to be made. These decisions are based on several factors, including:

  • Fibroid size
  • The number of fibroids
  • Where in the uterus the fibroids are located
  • The experience of the surgeon

Are there different types of myomectomy?

There are three main types of myomectomy:

  • Open myomectomy
  • Minimally invasive laparoscopic myomectomy
  • Hysteroscopic myomectomy

Open myomectomy

An open myomectomy, also known as abdominal myomectomy, is done through an incision in the abdomen. The incision may go up and down or across like a bikini cut. This type of procedure may be the best option for extremely large fibroids, though many times this can be done in a minimally invasive way as well. Recovery after an open myomectomy is similar to any other major surgery. Recovery will include:

  • A few days in the hospital
  • Up to six weeks at home before you feel 100%

Possible complications of an open myomectomy can include:

  • Bleeding
  • Infection
  • Damage to other organs
  • Anesthetic (pain-numbing medications used during surgery) mishaps

These complications are uncommon and your healthcare team will make every effort to avoid these problems.

Minimally-invasive myomectomy

There are several types of minimally-invasive options for a myomectomy. These surgeries generally have quicker recovery times and are easier on your body.

  • Standard laparoscopic myomectomy: This procedure uses a small, lighted telescope that is inserted through the belly button (umbilicus). Several other small incisions are made in other places in the abdomen for the placement of special instruments to assist in removing the fibroids. The fibroids themselves are sometimes removed through the vagina, or through the small openings in the abdomen. Some surgeons use a specialized machine (a robot) to finely control the movement of instruments during this type of surgery.
  • Single port myomectomy: This surgery uses only one opening near the belly button (umbilicus) for all the instruments. This results in a slightly larger incision in the belly button, but no other openings on the abdominal wall.
  • Hysteroscopic myomectomy: This procedure requires no incisions at all. When fibroids are in just the right place within the uterus, a camera with a specialized attachment can be placed through the vagina into the uterus to remove fibroids.

All of these minimally-invasive approaches have similar outcomes and complications.

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