The four- to six-inch incision (sometimes referred to as a "bikini" incision) is created on the abdomen, just below the pubic hairline. Depending on the location of the fibroids, it may also be done as a vertical incision in the midline area. During the procedure, the surgeon is able to feel the uterus, which is helpful in fibroid removal and in locating fibroids that may be deep in the uterine wall.
There is no limit to the size or number of fibroids that can be removed during a traditional abdominal myomectomy, which is a key advantage. The disadvantage is the incision, which leaves more scarring and requires a longer recovery. Careful repair of the uterus by a highly experienced surgeon is required for successful removal, healing and fertility preservation.
Myomectomy can also be performed with small incisions using a minimally invasive laparoscopic approach. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated myomas), or close to the outer surface (subserous myomas), are the easiest to remove laparoscopically. If they are deep inside the wall of the uterus, a traditional myomectomy will likely be advised.
Robotically Assistated Myomectomy
For any surgical procedure, superior control and precision are important, especially when considering the delicate tissues of the uterus. Guided by the experienced hands of our talented surgical team, the da Vinci allows for a greater level of precision when utilized in delicate procedures. Its tiny instruments require smaller incisions and disturb less surrounding tissue—greatly reducing pain, scarring, recovery times and hospital stays. In fact, the world's first robotic myomectomy was performed by Florida Hospital’s medical director of the gynecologic robotic surgery program.
The surgeon guided da Vinci system offers many potential benefits over traditional open surgery, including:
- Significantly less pain
- Less blood loss and fewer transfusions
- Minimally invasive option for removing large, numerous, hard-to-reach fibroids
- Fewer complications and risk of infection
- Shorter hospital stay
- Faster recovery and return to normal activities
- Small, dime-sized incisions for improved cosmetic results