Surgery: Fibroid removal

Choosing to have fibroid surgery is never a simple decision. We provide you with the resources to make a well-informed choice for your treatment. We are also equipped with the latest advancements, so you have a range of options to choose from.

If you need surgery, we remove just the fibroids whenever possible. This procedure is called a myomectomy. However, some women need a hysterectomy, or removal of the uterus, as well.

UCLA Health is proud to offer the latest technology and surgical expertise in robotic-assisted and laparoscopic myomectomy. Surgeons with board certification from the American Board of Obstetrics and Gynecology perform all of our surgeries.

What is myomectomy?

Myomectomy removes fibroids (myomas) while preserving the healthy tissue of the uterus. It’s best for women who want to keep their uterus, particularly if they wish to have children after fibroid treatment. Doctors consider this procedure the standard of care for removing fibroids and preserving the uterus.

Using MRI before your surgery allows us to better see the size, number and location of the fibroids. Our sophisticated imaging means we can tailor your treatment and safely offer less invasive alternatives, such as hysteroscopic myomectomy and laparoscopic myomectomy.

Types of myomectomy include:

Hysteroscopic myomectomy 

A hysteroscopic myomectomy removes fibroids through the vagina without an incision. The procedure is particularly helpful for submucosal fibroids.

While these fibroids often cause severe bleeding and anemia (when you don’t have enough red blood cells), they are easily spotted and removed with the hysteroscopic approach. (Learn more about what fibroids are, including the three main types.)

During the procedure, the surgeon:

1. Passes a long, thin instrument with a camera and light through the vagina and cervix into the uterus
2. Looks inside your uterus for fibroids and other problems, such as polyps
3. Removes growths using a device attached to the camera

Hysteroscopic myomectomy is relatively quick, usually about 30 minutes. You can go home after the procedure. There is minimal recovery.

Laparoscopic myomectomy 

During laparoscopic myomectomies, surgeons view and access the pelvis through a few small incisions. Each incision is about a centimeter or less. Your surgeon removes each fibroid through one of these incisions.

Surgeons know whether to recommend the laparoscopic approach after looking at your MRI results. The scans can show if the fibroids are safe to remove this way, given their size and number.

Laparoscopic myomectomy can take two to four hours, based on the number of fibroids and their size. You can go home the same day or spend a night in the hospital, depending on how you feel after the procedure. Overall recovery is about two to four weeks.

Robotic-assisted myomectomy 

Robotic-assisted myomectomy is an enhanced form of laparoscopic myomectomy. The specialized instruments are connected to robotic arms guided by the surgeon. This extra tool enhances surgeons’ nimbleness and precision and helps them see better during the procedure. The incisions and recovery are similar to laparoscopic myomectomy.

Abdominal myomectomy 

An abdominal myomectomy (or open myomectomy) removes fibroids through an incision in the abdomen, ideally on the bikini line. For large fibroids and multiple fibroids, it can be challenging for surgeons to get a good view. Taking this approach allows the surgeon to easily see pelvic organs.

The hospital stay after abdominal myomectomy lasts from one to three days. The recovery time generally lasts up to six weeks.

The surgery is typically very successful. It ensures that doctors can remove all of the fibroids.