Application and Clinical Results of Minimally Invasive Surgery in Patients with Uterine Fibroids: A Single-Centre Study in Azerbaijan

Objective: This single-centre retrospective study aimed to evaluate the efficacy, safety, and clinical outcomes of laparoscopic myomectomy laparoscopic myomectomy (LM) for uterine fibroids in a resource limited clinical setting. Materials and Methods: The medical records of 406 patients with uterine leiomyomas who underwent laparoscopic myomectomy between 2019 and 2024 were analyzed. Data included myoma characteristics (localization, number, and size), intraoperative parameters, complications, and postoperative outcomes (symptom resolution and fertility rates). Results: Among the 406 procedures, most patients were nulliparous (81.8%) and presented with abnormal uterine bleeding (69.7%). The mean diameter of the largest fibroid was 6.2 ± 2.1 cm, with a range of 3–10 cm, with solitary fibroids in 62.3% of cases. Subserosal (48.1%) and intramural (41.4%) localizations were the most common. Intraoperative blood loss was <100 mL in 52.5% of the cases. Laparoscopic resection was successfully completed in 394 cases (97.0%), while 12 cases (3.0%) required conversion to laparotomy due to dense adhesions, intraoperative hemorrhage, or technical limitations. At the 12-month follow-up, symptom resolution rates were 92.1% for bleeding, 88.6% for pelvic pressure, and 76.9% for infertility, with 33.3% of fertility-seeking patients achieving pregnancy. Conclusion: Laparoscopic myomectomy demonstrated safety and efficacy as a primary treatment for uterine fibroids in resource-limited settings, with high symptom resolution and favorable fertility out comes. This minimally invasive approach should be prioritized where surgical expertise is available, even in low-equipment environments.