Laparoscopic Myomectomy: Fibroid Removal Without Hysterectomy
Laparoscopic myomectomy removes uterine fibroids through small incisions while preserving the uterus — the surgical option for women who want definitive fibroid treatment without losing the uterus. Each fibroid is individually removed, the uterine wall is repaired in layers, and the uterus remains in its anatomical position.
The appeal of myomectomy over hysterectomy is uterine preservation — whether for fertility, personal preference, or both. The tradeoff is the possibility of fibroid recurrence, which does not exist after hysterectomy. Dr. Andrei discusses this tradeoff clearly at every myomectomy consultation.
Laparoscopic myomectomy is performed at McLaren Lapeer, McLaren Flint, and Henry Ford Rochester hospitals for all cases. Straightforward single-fibroid myomectomy may be appropriate at Lapeer County Surgery Center for selected outpatient cases.
Laparoscopic Myomectomy — Candidacy
Laparoscopic myomectomy is appropriate when the fibroid number, size, and location make laparoscopic removal and uterine reconstruction technically feasible.
Subserosal fibroids
Fibroids growing outward from the uterine surface — the most accessible for laparoscopic removal with straightforward excision and minimal reconstruction.
Pedunculated fibroids
Fibroids hanging from the uterus on a stalk — removed by cutting the stalk laparoscopically, typically the simplest myomectomy type.
Manageable intramural fibroids
Fibroids within the uterine muscle requiring deeper dissection and multilayer closure. Manageable numbers and sizes can be addressed laparoscopically.
Fertility preservation as primary goal
Women planning future pregnancy for whom hysterectomy is not acceptable and the fibroid burden is surgically addressable with myomectomy.
Prior failed medical fibroid management
Women who have tried GnRH agonists or hormonal IUD without adequate or lasting relief and are now candidates for surgical removal.
Preference to preserve the uterus
Women who have completed childbearing but prefer uterine preservation as long as myomectomy is technically feasible for their fibroid burden.
What Laparoscopic Myomectomy Involves
Laparoscopic myomectomy is more technically demanding than hysterectomy because it requires not only fibroid removal but also precise multilayer reconstruction of the uterine wall. The quality of the uterine repair matters — particularly for women planning future pregnancy.
Dr. Andrei performs laparoscopic myomectomy in a systematic sequence designed to minimize blood loss and achieve secure uterine reconstruction.
- Vasopressin injection to reduce fibroid bed blood loss
- Incision over each fibroid with electrosurgical energy
- Sharp dissection to deliver the fibroid from its pseudocapsule
- Multilayer uterine wall closure with absorbable suture
- All removed tissue sent to pathology for histologic confirmation
Laparoscopic myomectomy is primarily performed at hospital affiliations. LCSC is appropriate for selected straightforward single-fibroid outpatient cases.
- McLaren Lapeer Hospital — Lapeer, MI (all cases)
- McLaren Flint Hospital — Flint, MI (all cases)
- Henry Ford Rochester Hospital — Rochester Hills, MI (all cases)
- Lapeer County Surgery Center — selected straightforward outpatient cases
“The uterine repair after myomectomy is as important as the fibroid removal. A well-closed uterine wall heals properly and supports future pregnancy. I close every fibroid bed in layers, the same way I would repair any surgical wound that needs to hold.”
Consultation Through Recovery
Laparoscopic myomectomy at Lapeer Women’s Health follows a structured evaluation and recovery process.
Consultation and Imaging
Dr. Andrei reviews your ultrasound or MRI to characterize fibroid number, size, location, and relationship to the endometrial cavity. She determines whether laparoscopic myomectomy, robotic myomectomy, or hysterectomy is most appropriate.
Pre-Operative Optimization
Selected patients benefit from GnRH agonist therapy (Lupron) before myomectomy to reduce fibroid size and vascularity. Pre-operative iron supplementation for anemia is coordinated when needed.
Surgery and Discharge
Under general anesthesia, Dr. Andrei removes the fibroids and closes the uterine wall in layers. Duration is one to three hours. Most patients go home the same day or after one overnight stay.
Recovery and Pregnancy Timing
Dr. Andrei sees you at two weeks and confirms healing. For women planning pregnancy, the recommended waiting interval before attempting conception is discussed — typically three to six months.
Recovery After Laparoscopic Myomectomy
Recovery from laparoscopic myomectomy is similar to other laparoscopic GYN procedures — measured in weeks, not months.
Same-day or next-morning discharge. Pelvic cramping and incisional soreness managed with oral medication. Light walking from day one.
Desk work and light household tasks progressively resume. Driving resumes once off narcotic medication.
Most women return to full activity within two to four weeks. For future pregnancy: waiting interval of 3–6 months is recommended after uterine repair.
Questions About Laparoscopic Myomectomy
Fibroids Removed.
Uterus Preserved.
Laparoscopic myomectomy is the procedure when symptom relief and uterine preservation are both priorities. Schedule a consultation with Dr. Andrei to determine whether it is the right approach for your fibroid burden.
The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.