What are the advantages of laparoscopic myomectomy over abdominal myomectomy?

So there are lots of advances to a laparoscopic myomectomy compared to open surgery. If you just take recovery, typically laparoscopic myomectomies, which means doing keyhole surgery for fibroids, our patients stay in as either day cases or overnight stay. They're all back at work two weeks later, and most of them have 90% recovery within a week. If you have open surgery, most patients are spending at least two or three days in the hospital, many up to five days. They're typically taking six to 12 weeks off work and having 90% recovery at three or four weeks in. So big differences there. Cosmetically, there's some advantages. You're making these small incisions, one of which is hidden away in the belly button for the laparoscopic approach. Whereas abdominal incision is obviously a bigger scar. But there are other less obvious advantages. So our experience is that you get less adhesions, which is scarring inside the pelvis after laparoscopic surgery compared to open. This can be really important because we know adhesions can affect fertility in the future. They can cause pain in the future and they can make future surgery more complicated. Patients having laparoscopic myomectomy are less likely to have major blood loss and less likely to have blood transfusion as well. So these other features are really important, and I think what's poorly understood out there is just how many women who are currently having open surgery could actually have laparoscopic surgery. The old days where you could only treat one fibroid, which was any moderately sized, are long gone. We can now do large fibroids. And actually, if you have a single fibroid, there's essentially no upper limit to the size of fibroids that we can manage. The biggest fibroid I've taken out personally weighed more than 1.4 kilos, and that was a laparoscopic procedure. And I've taken up to 20 fibroids out laparoscopically, and this is not just my experience. This is experience reported worldwide.