Surgery is needed when fibroids cause symptoms and infertility, or when removal is preferred.
Surgery to remove fibroids is called Myomectomy. There are various types of Myomectomy as described below.
Single Incision Laparoscopic Myomectomy where surgery is done with Just One Cut of 3cm at the belly button.
Laparoscopic Myomectomy where surgery is done with 3-4 cuts in the tummy, each measuring 1-2cm.
Conventional laparoscopic surgery involving 3-4 cuts carry distinct risks with every additional surgical incision. It also usually involves the use of power morcellator to cut fibroids to strips for removal. This involves additional risk to surgery.
Recovery is within the week and you can be back to normal activities in 2-3 weeks.
Transcervical Myomectomy or Transcervical Resection of Myoma (TCRM) removes Type 0,1,2 fibroids through the vagina and no abdominal cuts. It can be done as a day surgery.
It is a unique surgery done within the cavity of the womb. To do that, special instruments are pass through the vagina into the womb cavity. This surgery requires advanced surgical skill and precise handling of the special instrument.
Type 0, 1, 2 fibroids of up to 4cm can be removed. Recovery is within days and symptom relief is usually immediate.
Laparotomy Myomectomy is surgery with a big 10-12cm abdominal cut.
This is the traditional method of fibroid removal. It is now used for very large fibroids of > 10cm.
Although this form of surgery can be faster than laparoscopic myomectomy, the recovery usually takes 2 - 4 weeks longer, as there is more pain and risk of infection with the bigger cut. Post-surgery scarring called adhesions is also more common; and severe adhesions can reduce future fertility.