Laparoscopic Myomectomy & Fertility Restoration in Large Intramural Fibroid (8.5 cm)
Lead Surgeon: Dr. P. Shankari (MBBS, MD OG, DRM Kiel Germany, FMAS)
Patient History & Presentation
A 31-year-old nulliparous woman presented with severe menorrhagia, secondary dysmenorrhea, and primary infertility of 3 years duration. Ultrasound and MRI revealed a large 8.5 cm FIGO Type 3 intramural fibroid distorting the posterior uterine wall and endometrial cavity.
Surgical Approach (FMAS Protocol)
Under laparoscopic guidance (FMAS protocol), a posterior vertical hysterotomy was performed using vasopressin hydrodissection. The fibroid was enucleated intact without entering the endometrial cavity. Multi-layer barbed suture uterine reconstruction was completed to ensure myometrial integrity for future pregnancy.
Clinical Outcome & Follow-Up
Operative time 65 mins, blood loss <50 ml. Patient discharged within 24 hours. At 6-month follow-up, menstrual cycles normalized, cavity distortion resolved completely, and successful spontaneous conception occurred at 8 months post-op.