Regardless of the route of surgery (open, laparoscopic or cathodic), there are two types of surgery for uterine fibroids, one is the removal of fibroids that leave the uterus behind, and the other is the removal of the uterus, and there are different indications for the two types of surgery. The uterus has two roles, one is to give birth and the other is to have menstruation. The uterus has nothing to do with aging, and the estrogen and progesterone in the body are secreted by the ovaries. The choice of the surgical procedure depends mainly on the patient’s age and fertility requirements. For young women with fertility requirements, myomectomy is usually performed, while for patients who are close to menopause without fertility requirements, hysterectomy should generally be the appropriate choice. Although it is technically possible, as a physician, we would not recommend such a procedure at the risk of recurrence and the difficulty of secondary surgery. The following is an overview of myomectomy. Myomectomy can be performed open, laparoscopically, hysteroscopically, or cathodically. 1.Open surgery is the traditional surgery, usually an 8-10 cm (depending on the size of the fibroid) is done in the lower abdomen. This procedure is suitable for almost all fibroids, but the surgery is relatively more traumatic and the recovery is slower. 2.Laparoscopic technique is a popular surgical method in recent years, which is a surgical method to remove fibroids through 3-4 incisions of 0.5-2cm in diameter on the abdominal wall and through surgical instruments, which is popular among patients because of its small abdominal wall scars and fast recovery after surgery. Some people worry that the fibroids are bigger than the incision, how to remove them? In fact, there is no need to worry, there is now an instrument called myoma rotator, which can cut fibroids into strips and remove them from the small hole. Laparoscopic surgery has become a major treatment modality for fibroids nowadays. However, this procedure requires high surgical skills and hospital equipment, so not every hospital can perform this procedure. Not all fibroids can be removed laparoscopically, so what kind of fibroids are suitable for laparoscopic surgery? If there are too many fibroids, the laparoscopic surgery will not be able to reach the small ones due to the lack of touch, so there is a risk of missing them or making the surgery difficult due to too many fibroids. Therefore, at this time, I believe that if the preoperative ultrasound indicates more than 5 fibroids, then laparoscopic surgery should not be insisted upon. In addition, if the fibroids are too large, for example, more than 10 cm, then bleeding during surgery and difficulty in suturing are not considered preferable to laparoscopic surgery, and open surgery should be considered more appropriate. If there are patients with fibroids larger than 10cm and want to insist on laparoscopic surgery, preoperative application of some drugs can also be considered to reduce the size of the fibroids in order to obtain laparoscopic surgery of the fibroids, but the cost is expensive (each GnRH-a injection costs about 2000 yuan and requires 1-2 units). 3.Hysteroscopic surgery is mainly suitable for fibroids located inside the uterine cavity. Hysteroscopic removal of fibroids requires special equipment and the skill of the surgeon, so it is also a hospital and physician-dependent surgery; 4.Negative surgery There are two meanings, one is for certain submucosal fibroids, if the fibroids are completely prolapsed from the uterine cavity into the vagina, they can be removed completely from the vaginal route, and the other type of negative fibroid This type of surgery requires a high level of surgical skill and requires special requirements for the size, number and location of the fibroids, as they are incised through the posterior vaginal wall, generally speaking, they are suitable for fibroids up to 7 cm in diameter, up to 2 in number and close to the bottom. If the patient is suitable for a vaginal procedure, the postoperative pain is less (there are no sensitive painful nerves in the vagina so the pain is less severe), but the risk of postoperative infection is slightly higher because the vagina is a bacterial environment.