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What happens during fibroid removal surgery?

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To remove fibroids, a doctor inserts a lighted viewing instrument into the uterus either through the vagina in a hysteroscopy or through small or large incisions in the abdomen if performing a laparoscopy or laparotomy procedure, reports WebMD. This surgical removal of fibroids is called a myomectomy.

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A hysteroscopy is an outpatient procedure that a surgeon performs if the uterine fibroids on the inner wall have not penetrated into the wall, explains WebMD. The laparoscopic procedure extracts one or two fibroids growing on the outside of the uterus, provided they do not exceed 2 inches. Laparoscopy is often an outpatient procedure but may require a one-day hospital stay. The more invasive laparotomy requires hospitalization for up to four days and a recovery period of up to six week. Surgeons reserve this procedure for removing multiple fibroids, large fibroids, or those that reside deep within the uterine wall, and also to repair bowel or urinary conditions while minimizing the risk of damage to nearby organs.

Myomectomy of a certain type of fibroid, called a submucosal fibroid, often improves a woman’s chance of becoming pregnant, reports WebMD. Prior to surgery, gonadotropin-releasing hormone analogue, or GnRH-a, therapy may shrink the fibroids and reduce blood loss during the procedure. Women with bleeding fibroids experience improvements in anemia because the GnRH-a therapy stops the uterine bleeding. While myomectomy reduces the bleeding and pelvic pain that fibroids cause, the growths return in 10 to 50 percent of women.

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