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Laparoscopic myomectomy and other laparoscopic treatments for uterine leiomyomas (fibroids)

William H Parker, MD
Section Editor
Tommaso Falcone, MD, FRCSC, FACOG
Deputy Editor
Sandy J Falk, MD, FACOG


Laparoscopic techniques provide minimally invasive options for many gynecologic procedures. Myomectomy, the removal of uterine leiomyomas (myomas or fibroids), can be performed laparoscopically in selected women. Other laparoscopic procedures have been developed for leiomyoma treatment, including uterine artery occlusion and myolysis, but these are not commonly used.

Uterine leiomyomas are the most common type of pelvic tumor in women, with an approximately 70 to 80 percent lifetime risk [1-3]. There are a wide variety of treatments for leiomyomas, both pharmacologic and surgical. The choice of treatments depends upon many factors, including characteristics of the myomas, the patient, and surgical expertise.

Laparoscopic myomectomy and other laparoscopic procedures for uterine leiomyomas will be reviewed here. Abdominal, hysteroscopic, and vaginal myomectomy, as well as other approaches to the management of leiomyomas, are discussed separately. (See "Abdominal myomectomy" and "Hysteroscopic myomectomy" and "Prolapsed uterine leiomyoma (fibroid)" and "Overview of treatment of uterine leiomyomas (fibroids)".)


Laparoscopic myomectomy is primarily used to remove intramural or subserosal leiomyomas (figure 1). Intracavitary myomas (submucosal and some intramural myomas that protrude into the endometrial cavity) (figure 2) are difficult to remove during laparoscopic myomectomy. In addition, hysteroscopic myomectomy is the procedure of choice when only intracavitary myomas are removed, since it offers the advantages of a short recovery and minimal perioperative morbidity. Women with both submucosal and intramural/subserosal myomas may be candidates for concomitant laparoscopic and hysteroscopic myomectomy. (See "Hysteroscopic myomectomy", section on 'Patient selection'.)

Appropriate candidates for laparoscopic myomectomy are women with the following characteristics:

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Literature review current through: Dec 2017. | This topic last updated: Jan 14, 2018.
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