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This video demonstrates Laparoscopic Myomectomy for 20 CM large Intramural Fibroid Uterus performed by Dr. R. K. Mishra at World Laparoscopy Hospital. Uterine leiomyomas (myomas) are benign smooth muscle tumors arising from the myometrium. Most myomas do not cause clinical symptoms and do not require intervention. Nonetheless, the size and location of a myoma are important determinants of its potential to become symptomatic and cause problems ranging from infertility to life-threatening uterine hemorrhage. In the case of very large myomas, the procedure can be recommended as a routine procedure for patients only after its technical feasibility, complication rates, conversion rate, and long- experience as the surgeon. The author has reported a case of a large myoma being removed laparoscopically. If the surgeon’s ability to perform the procedure is unlimited, then, size does not matter for the performance of a myomectomy laparoscopically.

Watch this detailed laparoscopic myomectomy procedure for the removal of a 20 cm large intramural fibroid. In this surgery, minimally invasive techniques are used to safely and effectively remove a massive uterine fibroid while preserving the uterus.

Dr. R.K. Mishra and his expert surgical team demonstrate advanced laparoscopic skills, offering insights into:

Pre-operative planning for large fibroids

Step-by-step minimally invasive surgical techniques

Safe extraction and uterine repair

Recovery tips and post-operative care

This surgery highlights how laparoscopic myomectomy can be a safe and effective option even for very large fibroids, minimizing pain, scarring, and recovery time compared to traditional open surgery.

Uterine fibroids are one of the most common gynecological conditions affecting women of reproductive age. While many fibroids are small and asymptomatic, some can grow exceptionally large, causing pain, heavy menstrual bleeding, and pressure symptoms on the bladder or intestines. One such challenging scenario is the presence of a 20 cm intramural fibroid, which lies within the muscular wall of the uterus.

Traditionally, large fibroids often required open abdominal surgery (laparotomy) for removal. However, advances in laparoscopic surgery now allow even very large fibroids to be removed minimally invasively, offering faster recovery, less pain, and minimal scarring.

What is an Intramural Fibroid?

Intramural fibroids develop within the muscular wall of the uterus. They are the most common type of fibroid and can cause:

Heavy menstrual bleeding

Pelvic pain or pressure

Enlarged abdomen

Infertility or complications during pregnancy

When the fibroid grows to a size like 20 cm, it can mimic pregnancy and significantly impact a woman’s quality of life.

Laparoscopic Myomectomy for Large Fibroids

Laparoscopic myomectomy is a surgical procedure in which fibroids are removed from the uterus through small keyhole incisions, using advanced surgical instruments and a camera. Removing a 20 cm fibroid laparoscopically is technically demanding and requires extensive expertise.

Key Steps in the Procedure:

Preoperative Assessment: Detailed imaging (ultrasound or MRI) to determine the size, number, and location of the fibroid.

Anesthesia and Port Placement: General anesthesia is administered, and small incisions are made in the abdomen for laparoscopic instruments.

Fibroid Enucleation: The fibroid is carefully dissected from the uterine wall while minimizing blood loss.

Uterine Reconstruction: After removal, the uterine wall is meticulously sutured to maintain uterine integrity.

Specimen Removal: Large fibroids may be morcellated or extracted through specialized techniques to avoid spreading tissue.

Recovery: Patients typically recover faster than open surgery, with less pain and shorter hospital stay.

Benefits of Laparoscopic Myomectomy for Large Fibroids

Minimally invasive with smaller scars

Less post-operative pain and quicker recovery

Preservation of fertility

Reduced risk of infection and blood loss compared to open surgery

Conclusion

Even very large intramural fibroids, such as those measuring 20 cm, can now be removed safely with laparoscopic myomectomy in experienced hands. This procedure not only relieves symptoms but also preserves the uterus, offering hope for women who wish to maintain fertility or avoid extensive surgery.

Dr. R.K. Mishra, a pioneer in laparoscopic surgery, has successfully performed numerous such complex procedures, demonstrating the remarkable potential of minimally invasive gynecologic surgery.

Contact us
World Laparoscopy Hospital Cyber City, Gurugram, NCR Delhi INDIA : +919811416838 World Laparoscopy Training Institute Bld.No: 27, DHCC, Dubai UAE : +971525857874 World Laparoscopy Training Institute 8320 Inv Dr, Tallahassee, Florida USA : +1 321 250 7653