Surgery is never a simple decision. We aim to provide our patients with the resources to make well informed choices for treatment of their fibroids. We are equipped with the latest advancements to provide an array of surgical options. Surgical treatment options include fibroid removal (myomectomy) and hysterectomy procedures performed by board certified physicians of the American Board of Obstetrics and Gynecology.
UCLA is proud to offer the latest technology and surgical expertise in robotic and laparoscopic myomectomy.
Myomectomy
Myomectomy removes fibroids (the myomas) without taking out the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or who simply wish to maintain their uterus. This procedure is considered standard of care for removing fibroids and preserving the uterus.
Advances in our ability to assess the size, number, and location of fibroids via preoperative MRI has allowed us to tailor treatments and safely offer less invasive alternatives such as hysteroscopic and laparoscopic myomectomy.
Hysteroscopic Myomectomy
A hysteroscopic myomectomy removes fibroids through the vagina. In this procedure a long, thin instrument with a camera and light is passed through the vagina and cervix into the uterus. No incision is needed. The physician can look inside the uterus for fibroids and other problems, such as polyps. Submucous, or intracavitary, myomas are easily visualized and can be removed using a device attached to the camera. Although submucous fibroids can often cause severe bleeding and anemia, their management is straightforward with hysteroscopic myomectomy. The procedure is relatedly quick, usually about 30 minutes, and patients are sent home after the procedure with minimal need for recovery.
Laparoscopic Myomectomy
In laparoscopic myomectomy, surgeons can view and access the pelvis through a few, small incisions, about a centimeter or less, and subsequently remove each fibroid via these incisions. A patient’s candidacy for this procedure depends upon the results of the MRI, which can show the surgeon if the size and number of fibroids are safe to remove laparoscopically. This procedure can take two to four hours depending upon the number and size of fibroids. Patients can go home that same day or spend one night in the hospital depending on how they are feeling after the procedure. Overall recovery is about 2 to 4 weeks.
Robotic Myomectomy
Robotic assisted myomectomy is an expansion of laparoscopic myomectomy, with the exception that the specialized laparoscopic instruments are connected to robotic arms which are guided by the surgeon. This allows the surgeon to have enhanced dexterity, precision, and visualization.
Abdominal Myomectomy
An abdominal myomectomy (or open myomectomy) removes fibroids through an incision in the abdomen, ideally a bikini line incision. Abdominal myomectomy allows the surgeon to easily see pelvic organs which can be difficult to visualize for other treatment options when a patient has very large fibroids or multiple fibroids. The hospital stay can last from 1-3 days and recovery time is generally up to 6 weeks. The abdominal myomectomy is a procedure with great success and can ensure that all of the fibroids have been removed.
Related Information
UCLA Health Library:
What is robotic-assisted myomectomy? >
