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Myomectomy is a surgical procedure in which only the fibroids are removed, preserving the uterus. As an alternative to hysterectomy, one advantage of a myomectomy is that with the uterus in place, childbearing remains an option. A disadvantage of a myomectomy is that when the uterus remains in place, fibroids can recur, sometimes requiring additional surgery. Fibroids can be removed by hysteroscopic myomectomy, laparoscopic myomectomy or an open abdominal myomectomy, which are described in detail below.

Hysteroscopic myomectomy

Hysteroscopic myomectomy is a technique used to remove fibroids that are submucosal, or largely within the uterine cavity. A hysteroscope, a thin tube containing a video camera, is passed through the vagina and cervix and into the uterus to enable gynecology surgeons to visualize inside of the uterus. The fibroid is then removed by shaving it out with small instruments that are also threaded into the site through the small tube. There are no incisions with a hysteroscopic myomectomy. It is a day surgery procedure (patients typically leave the hospital one hour after the completion of the procedure) with a one-day recovery period.

Laparoscopic myomectomy

Laparoscopic myomectomy is a technique used to remove fibroids that are either deep in the muscle of the uterine wall, subserosal or on the outside of the uterus. This minimally invasive technique uses a laparoscopic technique to remove the fibroids through very small incisions. It does not require an overnight stay in the hospital; in fact patients typically leave the hospital two to four hours after the completion of the procedure and require only a one- to two-week recovery period.

Open myomectomy

Open myomectomy uses a traditional large abdominal incision to remove the fibroids. Most fibroids can be removed by minimally invasive techniques; the use of the open method is limited to women with specific situations where laparoscopic or hysteroscopic removal of fibroids is not appropriate. This procedure requires patients to stay in the hospital for several days and expect four to six weeks to recover fully.