Myomectomy (Fibroid Removal Surgery) in Delhi, India

A myomectomy (fibroid removal surgery) is a procedure used to remove fibroids (also called uterine leiomyomas) from the uterus. Unlike a hysterectomy, which removes the entire uterus, a myomectomy focuses only on taking out the fibroids while preserving the uterus. This makes it an important option for women who wish to keep their uterus for future pregnancies or personal reasons.

The surgery can be performed in different ways depending on the size, number, and location of the fibroids. The main goal is to relieve symptoms such as heavy bleeding, pelvic pain, or fertility issues, while maintaining the structure and function of the uterus.

There are different surgical approaches to removing fibroids, and the choice depends on their size, number, and location. Broadly, myomectomy (fibroid removal surgery) can be performed as an open surgery or through minimally invasive techniques. Open surgery involves a larger incision and is best for very large or multiple fibroids, while minimally invasive options use smaller or no incisions, leading to faster recovery, less pain, and smaller scars.

Open Myomectomy (Abdominal Myomectomy)

This is the traditional and most invasive type of myomectomy (fibroid removal surgery). The surgeon makes a single, large incision in the lower part of the belly, similar to a C-section, to reach the uterus directly. This method is often the best choice for a person who has many fibroids or very large ones that would be difficult to remove using a less invasive approach. Because it requires a larger incision, it is considered a major surgery with a longer recovery period, typically taking about four to six weeks. Patients will have more pain and a more significant scar compared to other methods.

Minimally Invasive Myomectomy

This is a broad category that includes all the procedures that use smaller incisions or no incisions at all. The key benefits are a faster recovery, less pain, and smaller scars. Within this group, there are three distinct types of procedures, chosen based on the location and size of the fibroids.

• Laparoscopic Myomectomy

This is a keyhole surgery where the surgeon makes several small cuts in the abdomen and uses tiny cameras and surgical tools to perform the procedure. This approach is generally used for a smaller number of fibroids that are not overly large. The recovery is much quicker than open surgery, often taking about two to four weeks.

• Robotic Myomectomy

This is a type of myomectomy (fibroid removal surgery) where the surgeon uses a special robot to assist with the surgery. The surgeon controls robotic arms to move the instruments with high precision. This offers the same benefits as a traditional laparoscopic procedure, such as a fast recovery and minimal scarring. The robotic technology can be particularly helpful for complex cases that qualify for a minimally invasive approach.

• Hysteroscopic Myomectomy

This is the most minimally invasive option and does not require any abdominal cuts. The surgeon gently inserts a thin, lighted tool through the vagina and cervix to access the inside of the uterus. This procedure is specifically used for fibroids that are located on the inside surface of the uterus. The best part of this procedure is that the recovery is very quick, often just a few days.

Choosing myomectomy (fibroid removal surgery) offers several advantages for women living with fibroids. In addition to removing the growths, the procedure helps restore comfort and overall well-being. Here are some of the key benefits the procedure offers:

• Preserve the uterus – Unlike hysterectomy, myomectomy removes only the fibroids and keeps the uterus intact.
• Maintain fertility – It offers women the chance to conceive and carry a pregnancy in the future.
• Relieve symptoms – Helps reduce heavy menstrual bleeding, pelvic pain, and pressure symptoms caused by fibroids.
• Improve quality of life – Eases discomfort, restores energy, and reduces the impact fibroids have on daily activities.
• Targeted treatment – Removes only the fibroids while leaving healthy uterine tissue untouched.
• Multiple surgical options – Can be performed through open or minimally invasive techniques, depending on the size and location of fibroids.

The risks of myomectomy (fibroid removal surgery) can vary depending on the type of surgery performed, the size and number of the fibroids, and the patient's overall health. Here are the main risks associated with a myomectomy:

Common Surgical Risks

• Blood Loss: Fibroids have a rich blood supply, and significant bleeding can occur during the surgery. This is one of the most common risks. In some cases, a blood transfusion may be necessary to replace lost blood. Doctors often take steps to minimize this risk, such as using special medications or techniques to reduce blood flow to the uterus during the procedure.
• Infection: As with any surgery, there is a risk of infection at the incision site or inside the uterus. Antibiotics are typically used to treat an infection if it occurs.
• Scar Tissue (Adhesions): Scar tissue can form after surgery, both on the uterus and around nearby organs like the bowels or bladder. This can sometimes cause pelvic pain or, in rare cases, lead to bowel blockages. Minimally invasive surgeries generally have a lower risk of adhesion formation than open abdominal surgery.
• Damage to Nearby Organs: Though rare, there is a small risk of unintentional injury to nearby organs like the bladder or intestines, especially if the fibroids are very large or close to these organs.

Risks Related to Future Pregnancy

• Uterine Rupture: Because the myomectomy (fibroid removal surgery) procedure involves making incisions in the uterine wall, it can weaken the uterus. This creates a rare but serious risk of the uterus tearing during a future pregnancy or labor, a condition called uterine rupture. To prevent this, doctors will often recommend that patients who have had a myomectomy deliver all future babies by Cesarean section (C-section). This risk is highest with open and laparoscopic procedures that involve deep cuts into the uterine muscle.
• Recurrence of Fibroids: A myomectomy (fibroid removal surgery) removes the fibroids that are present at the time of surgery, but it does not prevent new fibroids from growing. The chance of new fibroids appearing is higher for younger patients and for those with many fibroids.

Other Potential Complications

• Conversion to a Hysterectomy: In very rare cases, if uncontrollable bleeding or another major complication occurs during the surgery, the surgeon may need to remove the entire uterus (perform a hysterectomy) to protect the patient's health.
• Anesthesia Risks: As with any surgery requiring general anesthesia, there are risks of adverse reactions, which the anesthesiologist will discuss with the patient beforehand.

Understanding what to expect at each stage helps patients and their families feel more prepared and confident. The journey typically involves three key phases: preparation before the procedure, the day of surgery, and post-operative recovery.

Pre-Operative Preparation

• Medical Evaluation: A thorough medical assessment is performed to ensure a patient is healthy and ready for surgery. This includes a physical exam, and imaging like an ultrasound to get a precise look at the fibroids. Blood tests are also performed to check for any health issues that might affect the surgery. For instance, blood tests can detect anemia (a low red blood cell count) and identify the patient's blood type in case a transfusion is needed.
• Medication Adjustments: The medical team provides specific instructions on which medicines, particularly blood thinners, to adjust or stop before the surgery to minimise the risk of bleeding.
• Lifestyle Recommendations: Doctors often recommend that patients stop smoking, as it can slow down the healing process.
• Fasting Instructions: Patients receive specific instructions for when to stop eating and drinking before the surgery.
• Practical Planning: Patients are advised to arrange for help with household tasks, childcare, and transportation for a period of time after returning home.

On the Day of the Procedure

• Hospital Admission: Patients are admitted to the hospital, and the medical team performs final checks and preparations.
• Anesthesia: The anesthesiology team administers a general anesthetic so the patient is comfortable and asleep during the entire procedure.
• Surgical Process: The surgeon performs the myomectomy. The specific procedure (open, laparoscopic, robotic, or hysteroscopic) depends on the plan discussed with the doctor. The surgery's duration varies based on the number and size of the fibroids.
• Initial Recovery: After the surgery, the patient is taken to a recovery room where a nurse closely monitors them as they wake up from the anaesthesia. The patient is then moved to a hospital room.

Post-Operative Care and Recovery

• Pain Management: Some discomfort or pain is expected, and doctors manage it with prescribed medication.
• Early Mobilisation: The medical team encourages getting up and walking as soon as it is safe, which is usually within 24 hours. This is an important step to prevent complications and help speed up recovery.
• Activity Restrictions: Specific instructions outline what activities to avoid. This includes no heavy lifting, strenuous exercise, or using tampons or having intercourse for a certain period to allow the uterus to heal.
• Rehabilitation: While physical therapy is not always necessary for a myomectomy, gentle exercises may be recommended to help regain strength and mobility.
• Follow-up Visits: Regular follow-up appointments are scheduled to check on the healing process.

Max Hospitals stands at the forefront of gynaecological care, offering comprehensive solutions for women dealing with uterine fibroids. Here’s why patients and their families choose us. 

• Advanced Surgical Techniques: Max Hospitals employs the latest minimally invasive procedures, including laparoscopic and robotic-assisted myomectomy, to remove fibroids with precision and minimal recovery time.
• Highly Experienced Doctors: Our team comprises seasoned gynaecologists and surgeons with extensive experience in treating fibroids, ensuring personalised and effective treatment plans. 
• Comprehensive Care: From initial consultation to post-operative follow-up, Max Hospitals provides holistic care, addressing all aspects of your health and well-being.
• Patient-Centric Approach: We prioritise patient comfort and satisfaction, offering support throughout the treatment journey to ensure a positive experience.

How is a myomectomy different from a hysterectomy?

A myomectomy (fibroid removal surgery) removes only the fibroids from the uterus, preserving the uterus and maintaining fertility. In contrast, a hysterectomy removes the entire uterus, which means pregnancy is no longer possible. Myomectomy is usually chosen by women who want to relieve fibroid symptoms while keeping the option of future pregnancies.

How long does it take to return to normal activities after a myomectomy?

Recovery time depends on the type of surgery. Hysteroscopic or laparoscopic myomectomy (fibroid removal surgery) often allows a return to daily activities within 1–2 weeks, while open myomectomy may require 4–6 weeks. Your doctor will provide personalised guidance.

Will my menstrual cycle return to normal after myomectomy?

Many women experience reduced bleeding and fewer fibroid-related symptoms after surgery, and menstrual cycles often return to normal. However, this can vary depending on the size, number, and location of fibroids.

Can fibroids grow back after myomectomy?

Yes, new fibroids can develop over time. The likelihood is higher in younger women or those who had multiple fibroids removed. Regular check-ups help detect any recurrence early.

Is pregnancy safe after a myomectomy?

Pregnancy is possible after myomectomy (fibroid removal surgery), but your doctor may recommend waiting several months for the uterus to heal. In some cases, delivery by C-section is advised to reduce the risk of uterine rupture.

Will I have visible scars after surgery?

Scarring depends on the surgical approach. Minimally invasive procedures like laparoscopic or robotic myomectomy usually leave small, barely noticeable scars, while open surgery results in a larger abdominal scar.

Can myomectomy improve fertility?

If fibroids were causing infertility or recurrent miscarriage, removing them can improve the chances of conceiving. However, fertility outcomes depend on other individual factors as well.

Are there non-surgical alternatives to myomectomy?

Some women may benefit from medication or non-invasive procedures like uterine artery embolization. However, these may not remove all fibroids and might not be suitable for women wishing to maintain fertility.

How is pain managed after myomectomy?

Pain is usually controlled with prescribed medications. Minimally invasive procedures generally result in less pain compared to open surgery.

What happens if fibroids come back after a myomectomy?

While myomectomy removes existing fibroids, it does not prevent new ones from developing. If fibroids recur, the treatment approach will depend on factors such as the severity of symptoms, the size and location of the fibroids, and your future pregnancy plans. Options may include another myomectomy, medication to manage symptoms, or other procedures tailored to your needs. Your doctor will guide you on the safest and most effective course of action.

Reviewed by Dr. Usha M Kumar, Director - Obstetrics And Gynaecology, Robotic Surgery, Gynaecologic Laparoscopy, on 07 October 2025.