What is myomectomy?
A myomectomy is a type of surgery used to remove uterine fibroids. The goal of myomectomy surgery is to remove the fibroids that are causing the symptoms, and to reconstruct the uterus. Unlike hysterectomy, which removes the entire uterus, a myomectomy removes only the fibroids and puts your uterus back in place.

Before myomectomy surgery
The obstetrician and gynecologist should meet with you before the surgery to discuss:

Anesthesia methods
Any allergies you may have.
Medicines, herbs, and supplements you take and whether you need to stop taking them before surgery
Fasting before surgery, such as not eating or drinking after midnight the night before
Whether you need to undergo surgery or not
Necessary tests before myomectomy surgery
Tests that need to be done before surgery, such as images of the pelvic organs, a myomectomy means removing the fibroid. Fibroids are bundles of muscle fibers that grow in the uterus. They are almost always benign (non-cancerous).

How many ways can myomectomy be done?
If a person has symptoms such as pelvic pain, heavy periods of irregular bleeding and frequent urination in his uterine fibroids, he can perform a myomectomy in one of the following ways:

Open abdominal surgery
Myomectomy using laparoscopy
Hysteroscopic myomectomy
Open abdominal surgery
During this procedure, you will be put under general anesthesia. The surgeon first makes an incision from the lower abdomen into the uterus. This surgery can be done in two ways:

The doctor makes a 3- to 4-inch horizontal incision just above the pubic bone. This type of incision causes less pain and leaves a small scar, but may not be large enough to remove large fibroids.
In the second method, a vertical incision is made from below the belly button to the top of the pubic bone. This type of incision is rarely used today, but may work better for larger fibroids and to reduce bleeding.
After making the incision, the surgeon removes the fibroids from the uterine wall and then reattachs the muscle layers of the uterus. Those who use this method for surgery spend one to three days in the hospital.

Myomectomy using laparoscopy
Myomectomy is performed laparoscopically under general anesthesia. The surgeon makes four small incisions. Each of the incisions in the abdomen will be about ½ inch long. The abdomen is filled with carbon dioxide gas to help the surgeon see inside the abdomen.
Then the surgeon places the laparoscope in one of the incisions. A laparoscope is a thin, clear tube with a camera at one end. Small tools are placed in other cuts.
If the surgery is done robotically, the surgeon uses the robot arm to remotely control the instrument.
The surgeon may cut the fibroids into small pieces to remove them. If they are too large, the surgery may be changed to an abdominal myomectomy, making a larger incision in the abdomen.
Laparoscopy is a minimally invasive procedure. This method brings a faster recovery than the abdominal myomectomy method.
After that, the surgeon removes the instrument and releases the gas and closes the incisions. Most people who have this procedure stay overnight in the hospital.
Hysteroscopic myomectomy
This procedure is performed with local anesthesia or under general anesthesia.
The doctor inserts a thin instrument into the uterus through the vagina and cervix. They put a liquid in the uterus to make it bigger so they can see the fibroids more clearly.
Your surgeon will use a wire loop to shave off pieces of the fibroid. Then, the fluid washes away the removed parts of the fibroid. After this surgery, the person can go home the same day.
What is the best candidate for myomectomy surgery?
Myomectomy is one of the surgical procedures used for women with fibroids. Women who want to get pregnant in the future or want to preserve their uterus for another reason, should do this operation with the doctor’s opinion.

Unlike hysterectomy, which removes your entire uterus, in a myomectomy, uterine fibroids are removed and the uterus is put back in place. With this, there is a possibility of pregnancy

Myomectomy is a laparoscopic procedure
A small incision will be made in the navel. A tube with a camera attached to one end is inserted into the abdomen through the incision. It will be used for abdominal examination. Two or three more incisions are made in the abdomen. Other tools are inserted through these cuts. And the fibroid will be found and removed. The incisions are closed with sutures. The bandage will be placed on them.

Often due to the size of fibroids, if the condition cannot be treated laparoscopically, a larger surgery is required, where an abdominal incision is usually made along the “bikini line”. If the fibroids are very large, the incision may be made vertically. The stitches are often absorbable and disappear within 10 to 14 days. Other types of sutures should be removed 5 to 7 days after surgery.

This operation usually takes up to an hour, and immediately after that, the patient is taken to the recovery department to recover after anesthesia until he is fully awake.