Ioannis K. Raptis is an accredited physician (MIC II qualification) certified to perform advanced laparoscopic and hysteroscopic procedures of high complexity by the German Society for Gynecological Endoscopy (AGE). In cases where intra-abdominal tissue fragmentation is required, an innovative closed containment bag system is used to ensure patient safety in the event of malignancy (contained morcellation).
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Fibroids are benign tumors that develop within the wall of the uterus, mainly in women of reproductive age. These tumors usually grow gradually; however, in some cases, they may appear suddenly.
Fibroids are classified into three categories based on their location within the uterus: subserosal, intramural, and submucosal. Subserosal fibroids are those whose largest portion is located on the outer surface of the uterine wall. Those primarily found within the thickness of the uterine wall are called intramural fibroids. Finally, submucosal fibroids develop within the uterine cavity.
The discomfort and complications caused by fibroids depend on their size, number, and location within the uterus. The most common symptoms of fibroids are the following:
It is important to note that in rare cases, some fibroids may be malignant. This likelihood has been estimated at 1 in 300.
When removal of fibroids is required, laparoscopic myomectomy stands out as the safest and most effective treatment method.
The endoscopic, radical removal of fibroids without damaging healthy tissues not only relieves the woman from the symptoms of the condition but also restores the normal anatomy of the uterus without the risk of complications associated with conventional open surgery (bleeding, infection, wound-healing disorders, etc.). At the same time, the aesthetic outcome is excellent, as the incisions made to allow the surgeon access to the abdomen are microscopic.
Finally, laparoscopy offers significant advantages during the postoperative period, as pain is minimal, mobilization is immediate, and recovery time does not exceed 24 hours.
For the successful performance of laparoscopic removal of fibroids, patients are required to undergo an ultrasound and, in certain cases, an MRI scan. The results of these examinations are crucial, as they allow the surgeon to determine the exact location of the tumors to be removed. At the same time, the likelihood of a fibroid being malignant is evaluated.
Laparoscopy is a minimally invasive procedure, especially when compared to open abdominal surgery. This explains why recovery after laparoscopy is fast and virtually painless. The pain experienced by the patient upon awakening is minimal, mobilization is immediate, and within just 24 hours she can return to her daily routine. In many cases, hospitalization at the clinic is not required.
Incision care is simple and includes disinfection with a special antiseptic twice daily. No special adhesive dressings are required, and the patient may shower normally.
Finally, activities involving intense physical exertion (gym workouts, manual labor, etc.) should be avoided for 2–3 days in order to prevent abdominal pain.
Fibroids may be located on the outer surface of the uterus (subserosal), within the uterine wall (intramural), or inside the endometrial cavity (submucosal).
Some common symptoms include heavy or prolonged menstrual bleeding, abdominal pain, frequent urination, as well as infertility.
Depending on their size and location, fibroids may affect a woman’s ability to conceive or cause complications during pregnancy.
Although rare, a fibroid may be malignant – the likelihood is estimated at 1 in 300–500 cases.
Surgical removal of uterine fibroids may be necessary when they cause severe symptoms, such as heavy menstrual bleeding, pelvic pain, or pressure symptoms that affect a woman’s daily life. Additionally, fibroid removal may be recommended in certain cases of infertility or recurrent miscarriages, particularly when the fibroids distort the uterine cavity. The decision depends on the size, number, and location of the fibroids, as well as the patient’s symptoms and reproductive goals.
Laparoscopic fibroid removal (laparoscopic myomectomy) is performed through small incisions in the abdomen, minimizing damage to healthy tissues. Compared to open surgery, it generally offers less postoperative pain, a shorter hospital stay, faster recovery, and better cosmetic results. Furthermore, it allows fibroids to be removed while preserving the uterus, which is particularly important for women who wish to become pregnant in the future.
Recovery after laparoscopic fibroid removal is significantly faster compared to open surgery. Patients can usually begin moving around on the day of the procedure, while hospitalization typically lasts one day. A gradual return to light daily activities is possible, although full recovery may take several weeks. The exact recovery time depends on the size and number of fibroids removed, the extent of the surgery, and the patient’s individual recovery progress.
Before laparoscopic fibroid removal, a transvaginal ultrasound is usually performed, while a pelvic MRI may be required in certain cases. These examinations allow for an accurate assessment of the size, number, and location of the fibroids, helping the surgeon plan the procedure appropriately. Additionally, the necessary preoperative laboratory tests and anesthetic assessment are carried out, with particular attention to possible anemia caused by heavy menstrual bleeding.
