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This video demonstrates Laparoscopic Myomectomy for Posterior Wall Myoma performed by Dr. R K Mishra at World Laparoscopy Hospital. Multiple fibroids, including large fibroids, can be removed during a laparoscopic or robotic myomectomy procedure. Your surgeon will perform a thorough examination and review your MRI with you to plan the laparoscopic myomectomy.

Laparoscopic myomectomy is an advanced minimally invasive surgical procedure used to remove uterine fibroids while preserving the uterus. Posterior wall myomas present unique technical challenges because of their location close to vital pelvic structures such as the rectum and uterosacral ligaments. At World Laparoscopy Hospital, this procedure is performed and taught using standardized evidence-based laparoscopic techniques to ensure optimal patient safety and surgical outcomes.

Posterior wall fibroids often cause symptoms such as pelvic pain, heavy menstrual bleeding, infertility, or pressure symptoms. Laparoscopic management allows surgeons to remove fibroids through small abdominal incisions, reducing postoperative pain, blood loss, and hospital stay compared to open surgery. The procedure begins with proper patient positioning and creation of pneumoperitoneum followed by port placement under vision. Careful inspection of pelvic anatomy is crucial before incision over the fibroid capsule.

During laparoscopic myomectomy, diluted vasopressin may be injected into the myometrium to reduce bleeding. A precise incision is made over the fibroid using monopolar or harmonic energy. The myoma is then dissected carefully using traction and counter-traction techniques. Posterior wall myomas require meticulous dissection because visualization may be limited and there is a higher risk of bleeding if surgical planes are not maintained properly.

After enucleation of the fibroid, multilayer suturing of the myometrium is performed to restore uterine integrity and reduce the risk of uterine rupture in future pregnancies. Advanced intracorporeal suturing skills are essential, and surgeons trained in high-volume laparoscopic centers demonstrate better outcomes. Specimen retrieval is typically done using morcellation or endobag extraction techniques.

Postoperative recovery after laparoscopic myomectomy is usually rapid. Most patients can resume normal activities within a few days. Long-term outcomes show good symptom relief and preservation of fertility potential when performed by experienced surgeons.

Training programs emphasize not only surgical technique but also patient selection, complication prevention, and postoperative care protocols. The focus on structured surgical training ensures that surgeons can safely perform complex procedures such as posterior wall myoma removal using laparoscopy.