Uterine fibroids, medically known as leiomyomas, are the most common benign tumors affecting women of reproductive age. They can cause heavy menstrual bleeding, pelvic pain, pressure symptoms, infertility, and recurrent pregnancy loss. For women seeking fertility preservation or minimally invasive management, laparoscopic myomectomy is considered the gold standard procedure. World Laparoscopy Hospital (WLH), located in Gurugram, India, is a premier global center specializing in advanced laparoscopic surgeries, including myomectomy, offering world-class treatment with state-of-the-art facilities and highly experienced surgeons.

Why Laparoscopic Myomectomy?

Traditionally, myomectomy was performed through an open abdominal approach, which involved large incisions, significant blood loss, prolonged hospital stay, and extended recovery periods. With the advancement of minimally invasive techniques, laparoscopic myomectomy has emerged as the preferred method for women with symptomatic fibroids who wish to retain their uterus. The benefits include:

Smaller incisions with superior cosmetic outcomes

Reduced postoperative pain

Faster recovery and shorter hospital stay

Precise enucleation of fibroids with minimal blood loss

Preservation of fertility and uterine integrity

Reduced risk of adhesions compared to open surgery

At WLH, laparoscopic myomectomy is performed using cutting-edge equipment and advanced surgical techniques to ensure optimal outcomes for patients of all ages.

Patient Evaluation and Preparation

At World Laparoscopy Hospital, patient care begins with a thorough evaluation. Imaging studies such as transvaginal ultrasound or MRI are performed to assess the size, number, and location of fibroids. Blood tests are conducted to check hemoglobin and overall fitness for surgery. Patients are counseled extensively about the procedure, expected recovery, and fertility considerations. In certain cases, preoperative medical therapy, such as GnRH analogs, may be administered to reduce fibroid size and vascularity, facilitating easier surgery and minimizing blood loss.

Patients are admitted on the day of surgery or the day prior, and standard preoperative protocols are followed, including fasting, anesthesia assessment, and prophylactic antibiotics.

Surgical Technique at WLH

Step 1: Patient Positioning and Anesthesia
The procedure is performed under general anesthesia. The patient is positioned in the dorsal lithotomy position with a Trendelenburg tilt to allow bowel loops to move away from the pelvic field. A Foley catheter is inserted to keep the bladder decompressed.

Laparoscopic Access and Port Placement
A 10 mm umbilical port is used for the laparoscope, and additional 5 mm accessory ports are placed strategically to allow optimal instrument triangulation for dissection and suturing. Pneumoperitoneum is established either using a Veress needle or open (Hasson) technique.

Fibroid Identification and Vasopressin Injection
The uterus is carefully inspected, and fibroids are localized. Diluted vasopressin is injected into the myometrium overlying the fibroid to minimize bleeding during enucleation.

Myoma Enucleation
A linear incision is made over the fibroid using advanced energy devices or monopolar scissors. The fibroid is carefully dissected using traction-countertraction technique, following the natural cleavage plane between the fibroid and surrounding myometrium. Large fibroids may require piecemeal excision to facilitate removal.

Hemostasis and Uterine Reconstruction
Bleeding points are coagulated using bipolar cautery. The uterine defect is closed in two layers: a deep myometrial layer to restore structural integrity and a superficial serosal layer to minimize adhesions. Barbed sutures are commonly used for efficiency and secure closure.

Specimen Retrieval
Excised fibroids are removed through contained morcellation or a mini-laparotomy incision, depending on size. Contained morcellation prevents intra-abdominal tissue dissemination and reduces the risk of parasitic fibroids.

Final Inspection and Adhesion Prevention
The pelvis is irrigated to remove blood clots and debris. Hemostasis is confirmed, and adhesion barriers may be applied over the uterine repair site. Ports are removed, and incisions are closed meticulously.

Postoperative Care

Postoperatively, patients at WLH are monitored in a dedicated recovery unit. Most patients are discharged within 24–48 hours. Pain is managed effectively with oral analgesics, and early ambulation is encouraged to prevent venous thromboembolism. Patients are advised to delay conception for 3–6 months to allow complete healing of the uterine wall. Follow-up includes monitoring for symptom resolution, wound healing, and imaging when necessary to ensure uterine integrity.

Advantages of WLH Expertise

World Laparoscopy Hospital offers unmatched expertise in laparoscopic myomectomy, with benefits including:

Highly experienced surgeons trained in advanced laparoscopic techniques

Access to state-of-the-art laparoscopic equipment

Customized surgical approach based on fibroid size, location, and patient fertility goals

Comprehensive care including preoperative counseling and postoperative follow-up

Integration of advanced technologies such as barbed sutures and contained morcellation for safety and efficiency

Conclusion

Laparoscopic myomectomy at World Laparoscopy Hospital represents the pinnacle of minimally invasive gynecologic surgery. With a focus on precision, patient safety, and fertility preservation, WLH provides women with large, multiple, or complex fibroids a minimally invasive solution that ensures faster recovery, reduced complications, and excellent reproductive outcomes. The combination of advanced technology, expert surgeons, and patient-centric care makes WLH a global hub for laparoscopic myomectomy and other gynecologic procedures.