Uzm. Dr. Ertan Özen
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Gynaecological Surgery
Laparoscopic myomectomy
How laparoscopic myomectomy removes uterine fibroids through small abdominal incisions while keeping the womb, what the evidence says about symptom relief and fertility, which fibroids suit keyhole surgery, how it compares with open and hysteroscopic myomectomy, approximate costs in Turkey against the UK, US and Germany, recovery, risks and how to check a clinic.
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Prof. Dr. Zehra Neşe Kavak
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Laparoscopic myomectomy in Turkey: what it is and how it works
Laparoscopic myomectomy is keyhole surgery that removes uterine fibroids (leiomyomas) while leaving the womb in place. The surgeon makes three to four small cuts in the abdomen, inflates the abdomen with carbon dioxide gas, and works through a thin camera (laparoscope) and long instruments. Each fibroid is cut out of the uterine wall, the defect is closed in layers with sutures, and the fibroids are removed in pieces through a small incision, ideally inside a containment bag. Hospitals in Turkey offer it with conventional laparoscopic instruments or with a robotic platform.
The operation is aimed at women who have heavy periods, pelvic pressure, pain or fertility problems linked to fibroids and who want to keep their uterus. This guide explains how the operation works, which fibroids suit it, what it costs compared with the UK, US and Germany, what recovery looks like and what to ask a clinic. For the wider field see our gynecology treatments in Turkey.
How is a fibroid removed through keyhole incisions?
You have general anaesthesia and a catheter. A small incision at the navel admits the camera; two or three more, each about 5 to 12 mm, admit the instruments. The surgeon may inject a medicine such as vasopressin into the uterine wall to reduce bleeding. The uterine surface is opened over the fibroid, the fibroid is separated from the surrounding muscle and lifted out, and the wall is rebuilt with stitches in two or three layers. Careful closure matters because the repaired muscle has to hold during a future pregnancy.
Fibroids cannot be pulled out whole through a 1 cm cut, so they are divided. In 2014 the US Food and Drug Administration warned that morcellating tissue inside the abdomen can spread an unsuspected cancer, so many surgeons now use a bag or remove tissue through a slightly enlarged incision. Ask which method the hospital uses. The operation usually takes one to three hours depending on the number and size of fibroids.
Does laparoscopic myomectomy work for heavy bleeding, pain and fertility?
For the symptoms it targets the evidence is good. Removing the fibroids that cause heavy bleeding or pressure usually reduces both, and guidance from NICE and the American College of Obstetricians and Gynecologists (ACOG) lists myomectomy as the standard uterus-preserving surgical option. Compared with open myomectomy, trials show less blood loss, less pain, a shorter stay and a faster return to normal life, with similar symptom relief in suitable cases.
Two limits are worth knowing. First, fibroids can grow back, and some women need further treatment later; the risk is higher with many fibroids and at a younger age. Second, the effect on fertility depends on where the fibroids sit. Fibroids that distort the womb cavity may impair conception and removing them can help; the benefit of removing fibroids outside the cavity is less certain. A fertility specialist should review your case rather than assume surgery will bring pregnancy.
Which fibroids suit laparoscopic surgery, and which do not?
Fibroids are described by position: subserosal (on the outside of the womb), intramural (within the wall) and submucosal (bulging into the cavity). Laparoscopic myomectomy works best for a limited number of subserosal and intramural fibroids. Very large fibroids, many fibroids (often more than four or five), fibroids deep in the wall near the cavity or a very large uterus make laparoscopy harder, and an open operation may be safer. Purely submucosal fibroids are usually removed through the cervix with a camera, not through the abdomen; see hysteroscopic myomectomy.
A pelvic MRI or detailed ultrasound before surgery maps the number, size and position of each fibroid. Good candidates are women who want to keep their womb, have symptoms that justify surgery and have a pelvic scan that shows fibroids within what the surgeon can safely remove. If cancer is suspected on imaging, a different pathway applies.
Laparoscopic, open, robotic or hysteroscopic myomectomy, or an alternative?
The route depends mostly on the fibroids. Open myomectomy uses a larger lower-abdominal cut and suits very large or numerous fibroids. A robotic approach (see robotic myomectomy) gives the surgeon a 3D view and wristed instruments for suturing, though it is not proven to give better outcomes than skilled conventional laparoscopy and often costs more. Non-surgical options include uterine artery embolisation, which blocks the blood supply to the fibroids; read our guide to uterine artery embolisation. Hysterectomy removes the womb and ends fibroid problems, but also ends pregnancy.
| Approach | Best suited to | Typical limits |
|---|---|---|
| Laparoscopic myomectomy | A few subserosal or intramural fibroids; wish to keep the womb | Size and number of fibroids; needs advanced suturing skill |
| Open myomectomy | Large or many fibroids | Longer stay and recovery; larger scar |
| Hysteroscopic myomectomy | Submucosal fibroids inside the cavity | Not for fibroids in the wall or outside |
| Uterine artery embolisation | Women who prefer no surgery on the womb | Fibroids are not removed; fertility evidence is less clear |
Laparoscopic myomectomy cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for the operation with hospital stay, not hospital quotes. Each hospital confirms its own price in a written quote after reviewing your scan.
| Country | Approximate cost range |
|---|---|
| Turkey | €2,500 – €6,000 |
| United Kingdom | €5,500 – €10,000 |
| United States | €9,000 – €25,000 |
| Germany | €5,000 – €9,000 |
The price moves with the number and size of fibroids, the operating time, conventional versus robotic equipment, the length of the hospital stay and whether tests such as MRI are included. A package normally covers pre-operative blood tests, the surgeon and anaesthetist fees, two to three nights in hospital, medication, follow-up checks and airport transfers; ask for the list in writing.
Laparoscopic myomectomy recovery: what to expect week by week
Most women stay in hospital one to two nights. Shoulder-tip pain from the gas is common for a day or two, and walking the same day helps it pass. Light bleeding or discharge can continue for a couple of weeks.
| Time | What most women experience |
|---|---|
| Days 1–3 | Soreness, bloating, shoulder-tip pain; short walks; discharge from hospital |
| Week 1 | Tiredness; stitches or glue check; fly home once the surgeon agrees |
| Weeks 2–3 | Return to desk work for many; avoid heavy lifting |
| Weeks 4–6 | Exercise and sex resume with the surgeon's agreement |
| 3 months | Uterine wall has healed; many surgeons advise waiting this long before trying to conceive |
Plan on five to seven nights in Turkey so you can be reviewed before flying, and arrange a follow-up with a gynaecologist at home.
What are realistic results after fibroid removal?
Most women notice lighter periods from the first cycles after surgery and less pressure once the uterus settles. Fibroids that are removed do not return, but new ones can form. The surgeon will give you the pathology report, which confirms the tissue was benign. If you plan a pregnancy, ask what the operation notes say about how deeply the womb wall was opened: after deep incisions many obstetricians recommend a planned caesarean to reduce the small risk of the scar opening in labour.
What are the risks of laparoscopic myomectomy?
Every operation has risks. Reported complications include bleeding that needs a transfusion, infection, injury to the bladder, bowel or ureter, scar tissue (adhesions) that can affect fertility, conversion to open surgery and, rarely, an unexpected sarcoma found on pathology. Deep vein thrombosis is a risk of any surgery and travel; walking early and wearing compression stockings reduces it. A small number of women have hysterectomy as an emergency if bleeding cannot be controlled, which is why you should discuss consent for this beforehand. Patient information from the NHS, NICE and ACOG describes these risks and is worth reading before you travel.
How to choose a surgeon and hospital, and red flags
Look for a gynaecological surgeon with regular experience of advanced laparoscopic suturing, an operation in a licensed hospital with a blood bank and intensive care, and a written plan that states the number of fibroids expected, the approach and the price. Red flags include a quote issued without seeing your scan, promises of pregnancy, refusal to discuss conversion to open surgery and pressure to pay a deposit quickly. Read how our process works and ask for a plan through our free quote page.
Questions to ask the clinic
- How many laparoscopic myomectomies does the surgeon perform each year?
- Based on my scan, is keyhole surgery suitable, or might it convert to open surgery?
- How will the fibroids be removed from the abdomen, and will a bag be used?
- What is included in the price and what happens if I need an extra night or a repeat operation?
- Who will review my pathology report and my healing after I return home?
Hospitals with Gynaecology in Turkey
Frequently asked questions
It is keyhole surgery that removes uterine fibroids through small abdominal cuts while keeping the womb. The surgeon cuts each fibroid from the uterine wall, repairs the wall with stitches and removes the tissue through a small incision.
For fibroids that cause heavy bleeding or pressure, removing them usually reduces symptoms. Results depend on the number and position of the fibroids, and new fibroids can form later.
Approximate ranges are €2,500 to €6,000 in Turkey against about €5,500 to €10,000 in the UK. The price depends on fibroid number and size, equipment and hospital stay; the hospital confirms it in a written quote.
Most women leave hospital after one to two nights, return to desk work in two to three weeks and resume exercise at four to six weeks, if the surgeon agrees. The womb wall takes about three months to heal.
Neither suits everyone. Keyhole surgery gives less pain and a faster recovery for a few small to medium fibroids, while open surgery is safer for very large or numerous fibroids.
Many women do, and surgeons often advise waiting about three months for the wall to heal. Ask whether a caesarean will be recommended and have a fertility review if you have been trying for some time.
Yes. Removed fibroids do not return, but new ones can grow, particularly if you had many fibroids or were young at surgery. Follow-up scans help you and your doctor monitor this.
You are asleep during surgery. Afterwards expect soreness, bloating and shoulder-tip pain from the gas, usually eased with simple painkillers over a few days.
It is a well-established operation, but it carries risks such as bleeding, infection, injury to nearby organs and adhesions. Choosing an experienced surgeon and a hospital with blood bank and intensive care lowers the likelihood of problems.
Plan five to seven nights: one to two in hospital, then rest nearby so the surgeon can check you before you fly home.
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