Description

Laparoscopic myomectomy has become the preferred minimally invasive surgical option for women with symptomatic uterine fibroids who wish to preserve the uterus. Among the various types of fibroids, subserous fibroids—located on the outer surface of the uterus—are particularly well suited for laparoscopic removal. At World Laparoscopy Hospital (WLH), laparoscopic myomectomy is performed using standardized, evidence-based techniques combined with advanced laparoscopic training and technology to ensure optimal patient outcomes. The procedure begins with careful preoperative evaluation, including pelvic ultrasonography or MRI to determine the number, size, and location of subserous fibroids. Proper patient selection, counseling, and planning are crucial steps to minimize intraoperative challenges. At WLH, surgeons emphasize detailed anatomical assessment and strategic port placement to achieve maximum surgical ergonomics and safety. After induction of general anesthesia, pneumoperitoneum is created, and laparoscopic ports are inserted under direct vision. The uterus is examined to confirm the fibroid’s location. Vasopressin is often injected into the myometrium surrounding the fibroid to reduce intraoperative blood loss. A precise serosal incision is then made using energy devices, allowing clear exposure of the fibroid capsule. The fibroid is enucleated through gentle traction and counter-traction while maintaining meticulous hemostasis. Since subserous fibroids are relatively superficial, dissection is usually straightforward, preserving the surrounding myometrial tissue. Once the fibroid is removed, attention is directed toward uterine reconstruction. Layered suturing of the myometrium is performed using intracorporeal suturing techniques, a key skill emphasized during hands-on training at WLH, to restore uterine integrity and reduce the risk of future complications. The excised fibroid is retrieved using contained morcellation techniques to ensure safety. Final inspection of the pelvis is carried out to confirm hemostasis and rule out injury to adjacent structures. The minimally invasive nature of the procedure allows patients to experience reduced postoperative pain, minimal scarring, shorter hospital stay, and faster recovery compared to open surgery. In conclusion, laparoscopic myomectomy for subserous fibroids is a safe, effective, and fertility-preserving procedure when performed with proper technique and expertise. The step-by-step surgical approach followed at World Laparoscopy Hospital reflects global best practices and provides surgeons with comprehensive training in advanced minimally invasive gynecologic surgery. Through a combination of precision, technology, and structured education, WLH continues to set high standards in laparoscopic surgical care.