Laparotomic conservative myomectomy (removal of nodes with uterine preservation)
Preserving the uterus and the chance for motherhood in complex fibroids
Conservative myomectomy (resection) is a delicate organ-preserving surgery during which the surgeon removes only the tumor nodes (fibroids), leaving the uterus itself healthy and intact.
Today, many such interventions are performed through punctures (laparoscopically). But in cases where the nodes reach gigantic sizes, there are many of them, or they have deeply grown into the muscular wall, surgeons at St. Luke’s Clinic use laparotomic (open) access. This is the most reliable method that guarantees complete removal of tumors and the formation of a strong scar for future pregnancy.
Why is open surgery sometimes better than punctures?
When it comes to preserving an organ in complex diagnoses, laparotomy has undeniable advantages:
“Tactile control”: During open surgery, the surgeon can literally feel the uterus with their hands and find even the smallest, deeply hidden intramural nodes that are not visible on camera. This critically reduces the risk of disease recurrence.
Reliable layered suturing: After removing a large node, a deep “niche” remains in the uterine wall. The surgeon applies strong multi-row sutures, which forms a perfectly viable scar. This is the most important condition for the uterus to withstand the load during future pregnancy and childbirth.
Removal without fragmentation: Giant nodes are removed whole, which eliminates the risk of spreading altered cells throughout the abdominal cavity.
Indications for laparotomic myomectomy
Our gynecological surgeons recommend this approach in the following situations:
Presence of large and gigantic nodes (over 8–10 cm).
Multiple uterine fibroids (when there are many nodes and they deform the organ).
Deep and inconvenient (e.g., cervical or isthmic) location of fibroids.
The patient’s desire to definitely preserve the uterus for reproductive function (childbearing).
Heavy bleeding, anemia, pressure of the tumor on the bladder or rectum caused by large nodes.
How is the surgery performed at St. Luke’s Clinic?
Aesthetic incision: If possible, the surgeon makes a cosmetic transverse incision above the pubis (along the bikini line). Over time, it becomes a thin, light strip that is easy to hide under underwear. Only with very gigantic tumors is a vertical incision performed.
Anesthesia: The intervention is performed under modern general anesthesia. You will feel nothing.
Gentle surgery: The doctor enucleates each node, maximally preserving healthy uterine muscle tissue, coagulates vessels to reduce blood loss, and applies modern self-dissolving sutures.
Recovery: step by step
After open surgery, you will stay in the comfortable hospital of St. Luke’s Clinic (Banchery village) for 3 to 5 days. Our medical staff will provide effective pain relief and round-the-clock care.
Full tissue recovery takes 1.5–2 months. Doctors usually allow planning pregnancy after such an operation after 6–12 months, when a reliable scar has formed on the uterus.
The diagnosis of “large fibroid” is not a verdict for your femininity. Schedule an expert consultation with the gynecological surgeons at St. Luke’s Clinic.
