Are you or a loved one considering an abdominal myomectomy to remove uterine fibroids, and have questions or concerns about how it works? A patient education video from PreOp.com explains abdominal myomectomy surgery step by step, so you’ll know what to expect.* 

What is myomectomy and how is it done?

Myomectomy, or the surgical removal of uterine fibroids, can be performed in several ways: abdominal, laparoscopic, hysteroscopic, or vaginal. Abdominal myomectomy is an open surgery involving large incisions. It is useful for removing large fibroids, but is also the riskiest form of the surgery in terms of potential infection and blood loss. Laparoscopic myomectomy involves several small incisions and smaller tools. Vaginal myomectomy involves no incisions, but may not be appropriate for removing large fibroids. If you have large fibroids and are considering abdominal myomectomy, here is a breakdown of the procedure.

What your surgeon does during the procedure

On the day of the operation, you’ll be given general anesthesia so that you sleep through the procedure.

Your surgeon will begin the myomectomy by making either a vertical or horizontal incision in your lower abdomen. The horizontal incision is more common. The surgeon will then:

• Use an instrument called a “retractor” to pull the skin aside and expose your abdominal muscles
• Make a vertical incision to separate the muscles
• Pull the muscles aside and hold them in place with another retractor, which allows the fibroid to be visible
• Take hold of the fibroid using forceps, pulling it away from the wall of the uterus
• Cut the connection between the fibroid and the uterus, and remove the fibroid
• Stitch the uterine wall close
• Remove the muscle restractor, and sew the abdominal muscles together
• Close and stitch the incision in the skin 
• Apply a sterile bandage to the site

Recovery from abdominal myomectomy

Recovery after an abdominal myomectomy is different for each person, but typically takes four to six weeks. You may need to plan to take at least a couple of weeks off from work to allow your body time to heal. Your doctor may instruct you to avoid strenuous activities such as running or heavy lifting, though walking and gentle physical activity are generally recommended, to maintain muscle tone and prevent blood clots.

Anticipating any sort of surgery can cause anxiety, but understanding the process and the potential risks can help prepare and empower you. Speak openly with your doctor about your treatment options, to find the best option for your situation. 

*PreOp.com Patient Engagement – Patient Education. (2017, May 29). Myomectomy for Fibroids Surgery PreOp® Patient Education [Video]. YouTube. https://www.youtube.com/watch?v=MgxvsmMlqJ8