This video demonstrate Laparoscopic Myomectomy for Large Fibroid Uterus and Cholecystectomy in the same patient by Three Port. With advancements in minimal access surgery, combined laparoscopic procedures are now being performed for treating coexisting abdominal pathologies at the same surgery. In our center, we performed 245 combined surgical procedures from January 2001to December 2020. The combination included laparoscopic cholecystectomy, various hernia repairs, and gynecological procedures like hysterectomy, salpingectomy, ovarian cystectomy, tubal ligation, urological procedures, fundoplication, splenectomy. The most common procedure was laparoscopic cholecystectomy with another endoscopic procedure. As long as the basic surgical principles and indications for combined procedures are adhered to, more patients with concomitant pathologies can enjoy the benefit of minimal access surgery. Minimal access surgery is feasible and appears to have several advantages in the simultaneous management of two different coexisting pathologies

Laparoscopic Myomectomy for Large Fibroid Uterus and Cholecystectomy in the Same Patient by Three Port at World Laparoscopy Hospital

Advancements in minimally invasive surgery have revolutionized the management of complex gynecological and general surgical conditions. One remarkable example is performing laparoscopic myomectomy for a large fibroid uterus and cholecystectomy simultaneously using a three-port technique, a procedure successfully executed at the renowned World Laparoscopy Hospital. This approach not only demonstrates surgical innovation but also emphasizes patient-centric care by reducing operative trauma, hospital stay, and recovery time.

Understanding the Conditions

A large fibroid uterus is characterized by the presence of one or more benign uterine tumors (leiomyomas) that can cause heavy menstrual bleeding, pelvic pain, pressure symptoms, and fertility issues. Traditional open myomectomy often involves a significant abdominal incision, prolonged hospital stay, and longer recovery time.

Simultaneously, cholelithiasis, or gallstones, can lead to recurrent abdominal pain, nausea, vomiting, and risk of complications like cholecystitis or pancreatitis. Laparoscopic cholecystectomy is now the standard treatment, offering minimal scarring and quicker recovery compared to conventional surgery.

The Three-Port Laparoscopic Technique

The three-port laparoscopic approach represents a minimally invasive surgical marvel, requiring only three strategically placed small incisions. This technique demands high surgical skill, especially when addressing a large fibroid uterus alongside gallbladder removal. The ports are typically placed as follows:

1. Umbilical port – for the laparoscope to provide a panoramic view of the abdomen.

2. Two accessory ports – for the introduction of surgical instruments to perform dissection, excision, and suturing.

This setup allows simultaneous access to the uterus and gallbladder while minimizing patient discomfort and postoperative complications.

Advantages of Combined Surgery

Performing both myomectomy and cholecystectomy in a single session offers several key benefits:

• Reduced Anesthesia Exposure: One surgical session avoids the risks associated with multiple anesthetic events.

• Shorter Hospital Stay: Patients recover faster, as both conditions are addressed simultaneously.

• Lower Cost: Combining procedures reduces hospital and operative costs.

• Minimal Trauma: Small incisions minimize pain, scarring, and risk of infection.

• Early Return to Daily Life: Patients experience faster physical and psychological recovery.

Surgical Expertise at World Laparoscopy Hospital

At World Laparoscopy Hospital, surgeons employ cutting-edge laparoscopic instruments, high-definition imaging, and advanced hemostatic techniques to manage complex cases. The expertise of the surgical team ensures:

• Safe removal of large uterine fibroids while preserving uterine integrity for future fertility.

• Precise gallbladder excision without injury to surrounding structures like the bile duct.

• Seamless integration of two procedures in a single operative session with minimal blood loss and complications.

Postoperative Care and Outcomes

Patients undergoing this combined procedure typically experience:

• Rapid recovery due to minimally invasive techniques.

• Minimal postoperative pain managed with standard analgesics.

• Early ambulation and diet resumption, reducing the risk of thromboembolism and gastrointestinal complications.

• Excellent cosmetic outcomes, as only three small scars are visible.

Long-term follow-up indicates high patient satisfaction, effective symptom resolution, and restoration of quality of life.

Conclusion

The three-port laparoscopic myomectomy for a large fibroid uterus combined with cholecystectomy exemplifies the fusion of gynecological and general surgery in a minimally invasive framework. The procedure, perfected at World Laparoscopy Hospital, highlights the hospital’s commitment to innovation, surgical excellence, and patient-centered care. For patients with multiple coexisting conditions, this approach offers a safe, efficient, and transformative surgical experience, setting a benchmark for advanced laparoscopic surgery worldwide.