Understanding Fibroids, Broad Ligament Fibroids, and How Laparoscopic Myomectomy with a Morcellator Can Help

Published by Kiran Infertility Center, Hyderabad

Uterine fibroids are one of the most frequently discussed yet widely misunderstood conditions in women’s reproductive health. At Kiran Infertility Center Hyderabad, we believe that an informed patient is an empowered patient. Whether you have just received a fibroid diagnosis or have been living with symptoms for years, this guide will walk you through everything — from what fibroids are, to the rare but significant broad ligament fibroid, to exactly how large fibroids are removed using advanced Laparoscopic myomectomy Hyderabad and a specialized instrument called a morcellator.

What Are Uterine Fibroids?

Uterine fibroids — also called leiomyomas or myomas — are non-cancerous growths that develop from the smooth muscle tissue of the uterus. They are remarkably common: research suggests that up to 70–80% of women will develop fibroids at some point during their reproductive years, although many will never experience noticeable symptoms. But treatment is possible through Fibroid removal surgery Hyderabad.

Fibroids can vary significantly in size, ranging from tiny seedlings barely visible to the naked eye, to large masses that can distort the shape of the uterus and even become palpable through the abdominal wall. They can be solitary or multiple, and they can develop in different locations relative to the uterine wall:

• Intramural fibroids — the most common type, growing within the muscular wall of the uterus
• Submucosal fibroids — growing just beneath the inner lining of the uterus (endometrium), often causing heavy bleeding and fertility issues
• Subserosal fibroids — growing on the outer surface of the uterus, sometimes extending on a stalk (pedunculated)
• Cervical fibroids — developing in the cervical tissue, less common but potentially obstructive

What Causes Fibroids?

The exact cause of fibroids remains incompletely understood, but several factors are known to influence their development and growth:

• Hormones — oestrogen and progesterone stimulate fibroid growth; fibroids typically shrink after menopause when hormone levels fall
• Genetics — a family history of fibroids significantly increases a woman’s risk
• Age — fibroids are most common in women between 30 and 50 years old
• Ethnicity — studies consistently show that women of African descent develop fibroids more frequently and at a younger age
• Obesity and diet — excess body weight and diets high in red meat and low in green vegetables have been associated with higher fibroid risk

Symptoms of Uterine Fibroids

Many women with fibroids experience no symptoms at all — their fibroids are discovered incidentally during a routine pelvic exam or ultrasound. However, when symptoms do occur, they can range from mildly inconvenient to severely debilitating:

• Heavy, prolonged, or painful menstrual periods
• Bleeding between periods
• Pelvic pressure or a feeling of fullness
• Frequent urination or difficulty emptying the bladder
• Constipation or rectal pressure
• Lower back or leg pain
• Abdominal bloating or an enlarged abdomen
• Pain during sexual intercourse
• Difficulty conceiving or recurrent pregnancy loss

At Kiran Infertility Center Hyderabad, we take every symptom seriously. A thorough evaluation is the first step toward understanding the nature, size, and location of your fibroids — and planning the most appropriate course of treatment.

What Are Broad Ligament Fibroids?

Among the various types of fibroids, broad ligament fibroids are among the rarest and most complex. Understanding them requires a brief look at the anatomy they involve.

The broad ligament is a wide fold of peritoneum — the tissue lining the abdominal cavity — that drapes over the uterus, fallopian tubes, and ovaries, anchoring these organs to the walls and floor of the pelvis. It is not simply a structural support; it also serves as a conduit for blood vessels, lymphatics, and nerves supplying the uterus and ovaries.

A broad ligament fibroid is one that grows within this peritoneal fold, outside the uterus itself but nestled within the connective tissue that supports it. Because of this location — in close proximity to the ureters (tubes carrying urine from the kidneys to the bladder), uterine arteries, and pelvic nerves — broad ligament fibroids present unique challenges both in diagnosis and surgical management.

Why Are Broad Ligament Fibroids Different?

Unlike conventional uterine fibroids that are relatively straightforward to identify on imaging, broad ligament fibroids can be mistaken for ovarian tumours, pelvic cysts, or other adnexal masses. This diagnostic ambiguity means they are frequently identified later — sometimes only when they have grown large enough to cause significant symptoms or when a patient presents with fertility concerns.

Their complex location also makes them technically demanding to remove. A surgeon operating on a broad ligament fibroid must work with exceptional precision to avoid injuring the ureter or uterine vessels — structures that lie in very close proximity to the mass.

Symptoms of Broad Ligament Fibroids

The symptoms of broad ligament fibroids overlap with those of conventional fibroids but tend to have a more pronounced pressure and pain component due to the fibroid’s location in the pelvic connective tissue:

• Chronic pelvic pain or a dragging sensation in the lower abdomen
• Heavy or irregular menstrual bleeding
• Urinary frequency, urgency, or incomplete bladder emptying
• Bowel symptoms including constipation or difficulty with defecation
• Pain radiating to the back or thighs
• A palpable abdominal mass in larger cases
• Difficulty conceiving or recurrent miscarriage

Diagnosis: Ultrasound and MRI

At Kiran Infertility Center Hyderabad, diagnosis of broad ligament fibroids begins with a pelvic ultrasound, which can reveal a mass in the adnexal or broad ligament region. However, because ultrasound cannot always distinguish broad ligament fibroids from ovarian masses or other pelvic pathology, MRI (Magnetic Resonance Imaging) is frequently required for definitive diagnosis.

MRI provides exceptional soft tissue contrast and can delineate the fibroid’s precise relationship to the uterus, ureter, ovaries, and vascular structures — information that is absolutely critical for safe surgical planning. Our specialists at Kiran Infertility Center Hyderabad use this detailed imaging data to prepare for surgery with the highest level of precision.

Impact on Fertility

Broad ligament fibroids can impair fertility through several mechanisms: they may compress or distort the fallopian tube, compromise blood supply to the ovary on the affected side, or create mechanical obstruction within the pelvis. Early diagnosis and surgical treatment are therefore not only important for symptom relief — they are often essential for preserving and restoring a woman’s reproductive potential.

The Morcellator — The Key to Removing Large Fibroids Laparoscopically

With a clear understanding of fibroids and broad ligament fibroids established, we now turn to the most important question for many patients: how are these fibroids actually removed?

For fibroids of modest size, laparoscopic removal is relatively straightforward. But when a fibroid exceeds 8 cm in diameter — as broad ligament fibroids and large intramural or subserosal fibroids often do — a critical challenge arises. A laparoscopic port is only about 1 cm wide. A fibroid measuring 8, 10, or even 15 cm cannot pass through that opening in one piece.

This is precisely where the morcellator becomes essential.

What Is a Morcellator?

A morcellator is a specialized surgical instrument inserted through a laparoscopic port. It uses a rotating blade mechanism to carefully divide a large fibroid into smaller, elongated fragments inside the body. These fragments are then drawn out through the port one by one until the entire fibroid has been removed. The process is performed under direct laparoscopic vision at all times, with the surgeon in complete control throughout.

At Kiran Infertility Center Hyderabad, our experienced surgeons use the morcellator as part of a carefully structured surgical protocol, ensuring both efficiency and safety throughout the procedure.

Laparoscopic Myomectomy — The Complete Procedure

Laparoscopic myomectomy is the surgical removal of fibroids using minimally invasive techniques. Here is a complete overview of what the procedure involves at Kiran Infertility Center Hyderabad:

Before Surgery

A thorough pre-operative assessment is conducted, including blood tests, imaging review, anaesthetic evaluation, and a detailed discussion of surgical goals — particularly regarding fertility preservation. Patients are given clear instructions regarding fasting, medications, and what to expect on the day of surgery.

During Surgery

• General anaesthesia is administered
• Three to four small incisions (0.5–1 cm each) are made in the abdomen
• A laparoscope is inserted, providing a magnified, high-definition view of the pelvis
• The fibroid is carefully dissected from the uterine wall or broad ligament using electrosurgical instruments
• For large fibroids, the morcellator is introduced to divide the tissue into smaller fragments for extraction
• The uterus is meticulously repaired in multiple layers, restoring its structural integrity
• All incisions are closed with absorbable sutures

After Surgery

Recovery from laparoscopic myomectomy at Kiran Infertility Center Hyderabad is significantly faster than open surgery:

• Hospital discharge within 24–48 hours
• Return to light daily activities within 5–7 days
• Full recovery within 2–4 weeks
• Minimal visible scarring from the small port incisions
• Women planning pregnancy are typically advised to wait 3–6 months before attempting conception

Why Kiran Infertility Center Hyderabad?

Our team combines decades of reproductive surgical expertise with genuine compassion for every patient’s journey. We do not simply treat fibroids — we treat women, with a full understanding of how fibroid disease affects not just the body but also confidence, relationships, and the dream of building a family.

Contact Kiran Infertility Center Hyderabad today to schedule a consultation with our fibroid specialists.