This video demonstrate Laparoscopic myomectomy allows your surgeon to remove your fibroids through several small incisions. This may be done robotically. It's less invasive and recovery is faster than with abdominal myomectomy.

Laparoscopic myomectomy is one of the most advanced fertility-preserving surgical procedures used for the treatment of uterine fibroids. With continuous advancements in minimally invasive surgery, even large intramural myomas—which were previously managed mainly by open surgery—can now be safely treated laparoscopically in specialized centers such as World Laparoscopy Hospital (WLH). This approach offers excellent clinical outcomes, faster recovery, and improved patient satisfaction when performed by experienced laparoscopic surgeons.

Understanding Large Intramural Myoma

Intramural myomas are fibroids located within the muscular wall of the uterus. When these fibroids become large, they can cause symptoms such as:

• Heavy menstrual bleeding

• Pelvic pain or pressure

• Infertility or recurrent pregnancy loss

• Increased abdominal size or pelvic mass

Studies show that common indications for laparoscopic myomectomy include infertility, pelvic pain, abnormal uterine bleeding, and increasing fibroid size.

In laparoscopic series, intramural fibroids represent a significant proportion of cases, confirming that this minimally invasive approach is widely applicable to such lesions.

Why Laparoscopic Myomectomy for Large Intramural Myoma?

Modern evidence supports laparoscopic myomectomy as a safe and effective procedure—even for large or multiple fibroids—when performed by trained surgeons.

Key benefits include:

• Minimal blood loss

• Short hospital stay (often around 1–2 days)

• Low complication and conversion rates

• Faster return to normal activity

• Preservation of uterus and fertility

Clinical data demonstrate low complication rates and good symptom relief after laparoscopic myomectomy, with many patients showing improvement in pain and bleeding symptoms after surgery.

Long-term analyses also show that laparoscopic myomectomy is considered a gold-standard surgical option, offering low conversion to open surgery and early discharge—even in complex fibroid cases.

Challenges in Large Intramural Myoma Surgery

Large intramural fibroids are technically demanding because they:

• Are deeply embedded in the uterine muscle

• May cause heavy bleeding during enucleation

• Require meticulous multilayer uterine repair

• Need advanced suturing and hemostatic skills

However, case reports confirm that even giant fibroids (up to 17–20 cm) can be removed laparoscopically with proper surgical expertise and technique.

Step-by-Step Surgical Principles

Although exact steps may vary, standard laparoscopic myomectomy usually includes:

1. Patient Positioning and Port Placement
   Proper ergonomic port placement ensures access and instrument mobility.

2. Localization of Fibroid
   Intraoperative ultrasound or visual inspection helps confirm size and position.

3. Serosal Incision and Myoma Enucleation
   The fibroid is dissected carefully from surrounding myometrium.

4. Hemostasis
   Energy devices or vasoconstrictive agents help reduce bleeding.

5. Myometrial Reconstruction
   The uterine wall is repaired in one or two layers depending on defect depth.

6. Specimen Retrieval
   Large myomas are usually removed using morcellation or mini-lap extraction.

Studies show uterine closure is often performed in one or two layers based on depth of myometrial defect.

Role of World Laparoscopy Hospital

World Laparoscopy Hospital is a globally recognized center for minimally invasive surgery training and advanced laparoscopic procedures. It combines patient care with research and surgical education in laparoscopy, endoscopy, and robotic surgery.

WLH focuses strongly on:

• Standardized competency-based training

• Advanced laparoscopic surgical skills

• Hands-on training with live surgical demonstrations

• Continuous research and innovation in minimal access surgery

The institution has developed structured curricula to train surgeons in advanced endoscopic and laparoscopic procedures following international standards.

Patient Outcomes and Fertility Considerations

Many patients undergo laparoscopic myomectomy specifically to preserve fertility. Evidence suggests:

• Good symptom relief in majority of patients

• Possibility of pregnancy after surgery

• Low adhesion formation in some studies

Follow-up research shows improvement in pain, bleeding, and overall quality of life after myomectomy.

Conclusion

Laparoscopic myomectomy for large intramural myoma represents a major advancement in gynecologic surgery. With proper patient selection and skilled surgical execution, even large and deeply located fibroids can be safely removed using minimally invasive techniques.

At World Laparoscopy Hospital, the combination of advanced technology, structured training, and experienced surgeons ensures high-quality outcomes for patients and provides world-class learning opportunities for surgeons worldwide.

This approach not only improves surgical outcomes but also enhances recovery, preserves fertility, and supports better quality of life for women suffering from large intramural fibroids.