Get moving: Being active soon after fibroid removal surgery aids in recovery

This content is sponsored by The Center for Innovative GYN Care

Smaller, Fewer Incisions Improves Fibroid Patient’s Mobility Sooner: Beyond the Stirrups Part 2

Prolonged recovery from any surgery can limit a return to normal activity, including exercise routines. For invasive GYN procedures, like open, robotic or standard laparoscopic fibroid removal surgery, many patients require weeks of painful recovery from either one large or multiple abdominal incisions that can make even walking and performing daily tasks difficult.

When incisions and instruments have to pass deep within the abdominal muscles they are less safe and take a long time to heal. The incisions from these procedures have a higher likelihood of lacerating blood vessels and damaging nerves, but at minimum, they go through musculature that takes much longer to heal, and has a higher level of pain during the recovery.

Both the size and placement of incisions matter for faster recovery.


“When you are limited in mobility for an extended period of time, more than two weeks, muscles begin to decondition, or detrain,” said Paul MacKoul, MD. “Walking promotes the flow of oxygen throughout the body, and maintains normal breathing function. Gastrointestinal and urinary tract function are improved, and with improved blood flow, wounds heal faster. Every patient’s recovery is different and should be monitored by a physician, but gradual and measured increase in movement and activity can help prevent prolonged recovery times.”

The detraining effect compounds depending on how fit a patient was to begin with. According to studies conducted by the American College of Sports Medicine, and US Army Research Institute of Environmental Medicine two weeks of inactivity can lead to a decline in cardio fitness. For some patients, recovering for 2 months after surgery (which is often necessary for patient who undergo open procedures) can lead to a loss of all fitness gains.

Every fibroids patient is different and needs to follow the advice of her surgeon. That said, choosing a surgeon who can perform advanced and thorough fibroid removal techniques with small incisions placed strategically in the midline increases the chances of the patient having a faster recovery.


Patients recover faster when surgical procedures are performed thoughtfully with the smallest incisions possible. As laparoscopic surgical technology improves, highly skilled minimally invasive GYN surgeons are able to perform complex procedures using increasingly smaller incisions, while controlling blood loss and improving visibility. These techniques allow laparoscopic procedures to be performed thoroughly, with very low risk of conversion. This is an important development for women who suffer from fibroids, including very large fibroids. These advancements can be applied to hysterectomy procedures that use just two 5MM incisions placed in the midline, or an ultra-mini-laparotomy for myomectomy (removal of fibroids) when fertility can be maintained.

Removing large fibroids is often problematic for many surgeons, as controlling loss of blood is one of the main safety concerns throughout any procedure. So rather than attempt a laparoscopic approach, many women are told they must have an open procedure, or a procedure with a robot that could convert to an open procedure.


The DualPortGYN technique for hysterectomy and LAAM minimally invasive fibroid removal technique for fertility were developed by the minimally invasive GYN surgeons at The Center for Innovative GYN Care.

DualPortGYN uses two 5mm incisions, one at the bikini line and one at the belly button. Most hysterectomy procedures are completed in under an hour, and patient recovery is about a week. LAAM for fertility uses 2 small incisions, one 5mm incision at the belly button, and another 1.5 inch incision at the bikini line. Recovery is 10 days to 2 weeks for a return to a normal routine, and 3 months to begin trying to conceive. Myomectomy is not recommended for women who are past childbearing.

Strategic placement of tiny incisions through the midline of the abdomen bypass the lateral abdominal muscles completely, allowing for a safer surgery and faster recovery from hysterectomy or myomectomy procedures with minimal pain.

“Many of the women who have had this type of surgery came to us with the belief that they wouldn’t be a candidate for laparoscopic or non-robotic surgery because they thought their condition was too severe,” said Natalya Danilyants, M.D. “When they discover that minimally invasive surgery with an exceptional recovery is possible, and incisions that are practically non-existent after a couple of months, their lives are changed for the better.”

CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. CIGC minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind. Dr. Rupen Baxi, MD is a minimally invasive GYN specialist at CIGC with extensive fellowship training and a respected speaker and researcher. Book a consultation at The Center for Innovative GYN Care or call 888-787-4379.

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