Myomectomy

Myomectomy (my-o-MEK-tuh-me) is a surgical procedure to remove uterine fibroids — also called leiomyomas (lie-o-my-O-muhs). These common noncancerous growths appear in the uterus. Uterine fibroids usually develop during childbearing years, but they can occur at any age.

Laparoscopic myomectomy in infertility

In spite of its known advantages, laparoscopic myomectomy is still a debated operation, whose feasibility, indications, and risks are still matters of discussion.

Indications: Universally accepted indications include the presence of a submucous or intramural fibroid that distorts the uterine cavity, fibroids greater than 3 cm, and multiple fibroids. Feasibility: The feasibility of laparoscopic myomectomy has been already shown with numerous clinical studies.

The location and size of uterine fibroids are major determinants for making a decision about which surgical approach is the most feasible. A consensus gradually emerges that the maximal size must be 8-10 cm and the total number of fibroids should not exceed four. Some authors’ criteria for laparoscopic myomectomy are a single intramural or subserosal fibroid ≤15 cm or three or fewer fibroids of ≤5 cm, whereas, others believe in an individual choice based on pathological findings and surgical skill. It is prudent not to perform laparoscopic myomectomies with more than five to seven large myomas because in these cases, the procedure is excessively time-consuming and the surgeon can miss the smaller myomas after the uterus has been incised and repaired in too many places.