Laparoscopic Surgery (Fibroid Tumor Removal; Uterine Fibroid Removal) by Health Library Editorial Staff and Contributors
Definition: This surgery involves removing fibroids from the wall of the uterus (womb). Fibroids are noncancerous tumors in the muscle of the uterus.
Reasons for Procedure: Myomectomy is done to relieve problems caused by fibroids without doing a hysterectomy (removal of the uterus). These problems can include:
- Pelvic pain
- Back pain
- Pressure on the bladder
- Abnormal vaginal bleeding
- Difficulty becoming pregnant
- Discomfort during sexual intercourse
The symptoms caused by fibroids are often successfully controlled with this procedure. This may include a return to a normal menstrual cycle and the ability to become pregnant.
Possible Complications: Complications are rare, but no procedure is completely free of risk. If you are planning to have a myomectomy, your doctor will review a list of possible complications, which may include:
- Surgical wound infection
- Recurrence of fibroids
- Damage to other organs
- Wall of the uterus may be weakened if a large fibroid is removed
- Reactions to anesthesia
- Need for special precautions in pregnancy (eg, need to deliver by cesarean section)
- Pelvic adhesions that can cause pain and/or bowel blockage
- Problems found during surgery that make removal of the uterus necessary
- Severe scarring, resulting in infertility
Factors that may increase the risk of complications include:
- Chronic or recent illness
- Recent drug, tobacco, or alcohol use
- Use of certain prescription medicines
- Be sure to discuss these risks with your doctor before the procedure.
What to Expect
Prior to Procedure: Your doctor may do the following:
- Physical exam
- Blood tests
- Review your medicines
- Dilation and curettage (D&C): a procedure to remove tissue from the lining of the uterus (endometrium)
- Ultrasound shows images of pelvic organs
- Intravenous pyelogram: x-rays taken of the kidneys, ureters, and bladder after a contrast medium is injected into a peripheral vein (done if the fibroids are affecting the ureters)
You should discuss with your doctor:
- Whether you should have hormone treatment for 2-4 months before the procedure. This treatment shrinks fibroids. It makes them easier to remove and reduces the risk of excess blood loss during the procedure.
- If cancer is found in the uterus, one option is to remove the uterus during the myomectomy.
- Whether you should donate your own blood for the procedure
Leading up to your procedure:
- Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Arrange for a ride home from the hospital. Also, arrange for help at home.
- Do not eat or drink for at least eight hours before the procedure.
Anesthesia: General anesthesia is used most often. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
Description of the Procedure: The doctor will make a small cut in the navel. The doctor will insert a laparoscope into the abdomen through the cut. A laparoscope is a tube with a tiny camera on the end. The doctor will use this to examine the abdomen. Two or three additional small cuts will be made in the abdomen. Other tools will be inserted through these cuts. The doctor will find each fibroid and remove it. In some cases, you may be given the drug Pitressin to reduce blood loss. After the fibroids are removed, the doctor will use stitches to close the incision area.
Be aware that in some cases, the doctor may need to switch to an open surgery. During an open surgery, she will make a larger cut in the abdomen to do the surgery.
Immediately After Procedure: After the procedure, you will be:
- Taken to the postoperative area
- Watched for complications
- Given IV fluids and medicines
How Long Will It Take? 1-2 hours
Will It Hurt? Your doctor will give you pain medicine to help control the pain.
Average Hospital Stay: You will either stay overnight or leave the hospital the same day as your surgery.
Post-procedure Care: Full recovery will take about 2-4 weeks. When you return home, do the following to help ensure a smooth recovery:
- Be sure to follow your doctor''s instructions.
- Wear sanitary pads or napkins to absorb blood. The first menstruation after the procedure may be heavier than normal.
- Try to walk often. This will decrease the risk of blood clots.
- Take medicines as prescribed by your doctor. If you had to stop medicines before the procedure, ask your doctor when you can start again.
- Bathe or shower as normal. Gently wash the incision area with mild soap.
Ask your doctor when you will be able to:
- Return to work and drive
- Resume sexual activity
- Resume strenuous activity (You may need to wait 2-6 weeks.)
Call Your Doctor: After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Excessive vaginal bleeding (soaking more than one pad per hour) after the procedure
- Excessive vaginal discharge that continues beyond one month after the procedure
- Vaginal discharge has a foul odor
- Severe abdominal pain
- Headaches, muscle aches, dizziness, or general ill feeling
- Nausea, vomiting, constipation, or abdominal swelling
- Pain and/or swelling in one or both legs
- Fibroid symptoms return after the procedure
- Cough, shortness of breath, or chest pain
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- New, unexplained symptoms
In case of an emergency, CALL 911.
The American Congress of Obstetricians and Gynecologists
National Uterine Fibroids Foundation