Fibroids are non-cancerous growths in the womb. Many cause no trouble at all, but when they lead to heavy periods, pelvic pain or pressure symptoms, removing them can make a real difference. A laparoscopic myomectomy removes the fibroids through small keyhole incisions while leaving your womb in place.

Who it suits

This operation is for women who want their fibroid symptoms treated but wish to keep their womb — whether for future pregnancy or simply by preference. It is best suited to fibroids of moderate size and number. Where fibroids are very large or very numerous, open surgery may be the safer choice, and we will tell you honestly if that applies to you.

Before surgery: how we assess you

Every woman having a myomectomy has ultrasound imaging — both abdominal and transvaginal — as a matter of routine. This tells us how many fibroids there are, how big they are, exactly where they sit in the womb wall, and whether their appearance is reassuring. That assessment is what determines the surgical approach we recommend and how we plan to remove the tissue.

You will also have a physical examination and blood tests before the operation.

What happens during the operation

Under general anaesthesia, the surgeon makes a small incision near your navel and passes a laparoscope — a thin telescope with a camera — into the abdomen. A few further small cuts allow the surgical instruments through. The fibroids are separated from the womb wall, and the wall is then repaired with stitches.

Removing the fibroid: morcellation

Because the incisions are small, a fibroid usually has to be cut into smaller pieces to be taken out. This is called morcellation.

The concern with morcellation is that if a fibroid contained an unsuspected cancer, cutting it up inside the abdomen could spread cells. This is rare, but it is taken seriously. Our practice is:

  • In-bag morcellation — the fibroid is placed inside a specimen bag before it is divided, so the tissue stays contained.
  • Direct morcellation is used in some cases where the preoperative assessment and the appearance at surgery indicate a benign fibroid.

Your surgeon will explain which approach is planned for you and why, based on your scan findings.

Benefits compared with open surgery

  • Smaller incisions and minimal scarring
  • Less blood loss
  • Less pain afterwards
  • A shorter hospital stay — often home the same day or the next
  • A quicker return to work and normal activity, usually within a few weeks

Risks

As with any operation, there are risks: bleeding, infection, injury to nearby organs, and anaesthetic complications. Occasionally a keyhole operation has to be converted to open surgery if difficulties arise. Fibroids can also recur over time, since myomectomy removes the fibroids present rather than preventing new ones. Your surgeon will go through all of this with you before you consent.

Recovery

You will be given instructions on caring for your wounds and managing pain, which is usually well controlled with simple painkillers. Most women are up and moving the same day. Avoid heavy lifting and strenuous activity for a few weeks, and attend your follow-up appointment so we can check your recovery.

If you are hoping to conceive afterwards, ask your surgeon how long to wait before trying — this depends on how deeply the womb wall was repaired.

The bottom line

Laparoscopic myomectomy treats fibroid symptoms while preserving your womb, with less pain and a faster recovery than open surgery. Careful ultrasound assessment beforehand and contained, in-bag morcellation during the operation are how we keep it safe. If fibroids are affecting your life, talk to a gynaecologist about whether this is the right option for you. You may also want to read our general guide to uterine fibroids.

References

  1. Royal College of Obstetricians and Gynaecologists. Morcellation for myomectomy or hysterectomy — information for you [Internet]. London: RCOG; [cited 2026 Jul 22]. Available from: https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/morcellation-for-myomectomy-or-hysterectomy-information-for-you/
  2. National Health Service. Fibroids [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/fibroids/
  3. Bean EMR, Cutner A, Holland T, Vashisht A, Jurkovic D, Saridogan E. Laparoscopic myomectomy: a single-centre retrospective review of 514 patients. J Minim Invasive Gynecol. 2017;24(3):485–493.