Minimally invasive surgery for fibroids

The well-recognized advantages of minimally invasive surgery, including a shorter hospital stay, and better patient convenience and recovery, can be offered with appropriate counseling to patients desiring to undergo myomectomy as a fertility enhancing treatment. Evidence available to date suggests that hysteroscopic and laparoscopic myomectomy may give the same results as open myomectomy in terms of restoring fertility and pregnancy outcome. However, the safety of nonextirpative surgical procedures, including myolysis and uterine artery embolization, has not yet been determined for women desiring pregnancy. Laparoscopic myomectomy and LAM, in carefully selected cases, is a safe and efficient alternative to myomectomy by laparotomy and can be performed in many cases even in the presence of large myomata. LAM, by decreasing the technical demands, and thereby the operative time, may offer better management, as it allows careful suturing of the uterine defect in layers and avoids excessive electrocoagulation.