This video demonstrates laparoscopic surgery for Round Ligament Fibroid Removal by Two Port by Dr. R.K. Mishra at World Laparoscopy Hospital.

Round ligament fibroids occur in the extraperitoneal portion of the ligament and are mostly seen to the right of the adnexa for still unknown reasons. These fibroids usually resemble an inguinal hernia, lymphadenopathies, ovarian cysts, and other pelvic masses because of the localization. There are several cases reporting management of round ligament fibroids via laparotomy in the literature. However, with recent advancements in laparoscopic surgery, laparoscopic approaches are more feasible and advantageous than laparotomy, with the additional benefits of a shorter hospital stay and recovery periods.

The diagnosis of round ligament fibroids is challenging. The presentation may be asymptomatic but must be kept in mind in the differential diagnosis of adnexal torsions. Laparoscopy can be the first choice where operation room settings are available.

Laparoscopic surgery has revolutionized gynecological procedures by offering safer, less invasive, and cosmetically superior outcomes compared to traditional open surgery. One such advanced technique is Laparoscopic Round Ligament Fibroid Removal using a Two-Port Method, which is gaining popularity for selected cases of extra-uterine or round ligament fibroids. At World Laparoscopy Hospital, surgeons are trained to perform such precision-based minimal access procedures using advanced laparoscopic skills and standardized protocols.

Understanding Round Ligament Fibroids

Round ligament fibroids are rare leiomyomas that arise from the smooth muscle fibers of the round ligament. These fibroids may present as pelvic masses, inguinal swelling, or chronic pelvic pain. Due to their uncommon location, they are sometimes misdiagnosed as ovarian cysts, inguinal hernias, or lymph node swellings. Imaging techniques such as ultrasound or MRI help in accurate preoperative diagnosis.

Two-Port Laparoscopic Technique

The two-port laparoscopic approach is a minimal access advancement that reduces the number of surgical entry points while maintaining safety and surgical efficiency.

Port Placement:

• One primary 10 mm umbilical port for telescope insertion

• One secondary 5 mm working port in the lower abdomen

This technique requires advanced laparoscopic hand-eye coordination and instrument handling, which are key training components at World Laparoscopy Hospital.

Surgical Steps

1. Creation of pneumoperitoneum and laparoscopic visualization

2. Identification of the round ligament fibroid

3. Careful dissection preserving surrounding structures

4. Bipolar coagulation and precise excision of the fibroid

5. Specimen retrieval using an endobag (if required)

Advantages of Two-Port Approach

• Minimal postoperative pain

• Faster recovery and early discharge

• Better cosmetic results

• Reduced risk of port-site complications

• Cost-effective due to fewer ports and instruments

Role of Advanced Training

Performing two-port laparoscopic fibroid removal demands high surgical expertise. World Laparoscopy Hospital focuses on simulation-based and hands-on training that helps surgeons master such advanced minimal access techniques safely.

Patient Outcomes

Patients undergoing this procedure typically experience rapid recovery, minimal blood loss, and early return to daily activities. When performed by trained laparoscopic surgeons, complication rates are extremely low.

Conclusion

Laparoscopic Round Ligament Fibroid Removal by the Two-Port technique represents the future of ultra-minimally invasive gynecologic surgery. With structured training and advanced surgical education, institutions like World Laparoscopy Hospital continue to lead in promoting safe and innovative laparoscopic procedures worldwide.