Laparoscopic Myomectomy and Contained In‑Bag Morcellation

Indications for Surgery

Laparoscopic myomectomy may be recommended when fibroids are causing significant symptoms, including:

• Heavy or prolonged menstrual bleeding

• Pelvic pain, pressure, or bloating

• Pain with intercourse

• Bowel or bladder symptoms related to fibroid size or position

• Reduced fertility or recurrent pregnancy loss where fibroids are implicated

Not all fibroids require surgery. Treatment decisions depend on symptoms, fibroid size and location, reproductive plans, and alternative management options.

How the Surgery Is Performed

The procedure is performed under general anaesthesia using small abdominal incisions. A camera and specialised instruments are inserted to allow precise removal of fibroids from the uterus. The uterine muscle is then carefully repaired to restore strength and function.

When fibroids are large, they are removed from the abdomen using contained in‑bag morcellation. This technique involves placing the fibroid tissue inside a sealed surgical bag before morcellation (division into smaller pieces). Contained morcellation is used to reduce the risk of tissue spread within the abdominal cavity and aligns with current safety recommendations.

Most patients are able to go home after an overnight stay.

Risks and Recovery

Laparoscopic myomectomy is generally safe, but risks include bleeding, infection, injury to surrounding organs (such as bladder, bowel, or blood vessels), blood clots, and anaesthetic risks. In rare cases, conversion to open surgery may be required.

Recovery usually takes 2–4 weeks. Future pregnancy is often possible, though delivery by caesarean section may be advised depending on the surgery performed.