Managing a large panmural fibroid uterus laparoscopically can be technically demanding because the fibroid may extend deeply through the uterine wall and alter the normal anatomy. This detailed surgical education video from World Laparoscopy Hospital focuses on the laparoscopic myomectomy approach used for a large fibroid uterus, with emphasis on operative planning, safe dissection, fibroid enucleation, bleeding control, and restoration of uterine anatomy.

Laparoscopic myomectomy offers a minimally invasive approach for selected patients who require removal of symptomatic uterine fibroids while retaining the uterus. In large panmural or deeply situated fibroids, the surgeon must carefully evaluate the location and extent of the lesion before beginning the procedure. Knowledge of uterine anatomy, appropriate energy use, traction and counter-traction, and advanced laparoscopic suturing plays an important role in successful surgery.

During myomectomy, controlled incision and development of the correct tissue plane can facilitate separation of the fibroid from surrounding myometrium. Once the fibroid has been removed, careful assessment of the uterine defect and appropriate multilayer suturing may be required to restore the integrity and shape of the uterine wall. Hemostasis throughout the procedure remains an important surgical consideration.

The management of large fibroids also demonstrates the importance of surgical judgment regarding access, instrumentation, tissue handling, specimen extraction, and uterine reconstruction. Advanced laparoscopic training allows surgeons to develop the technical skills required for complex gynecological procedures through supervised practice and exposure to real operative cases.

World Laparoscopy Hospital (WLH) provides specialized training and educational opportunities in minimal access surgery for surgeons and gynecologists. This video is designed as an educational resource for medical professionals interested in laparoscopic gynecological surgery and advanced myomectomy techniques.

Watch this surgical demonstration to understand the important steps and principles involved in laparoscopic treatment of a large panmural fibroid uterus and to learn how minimally invasive techniques can be applied to complex gynecological surgical cases.