Not all laparoscopic surgeons are trained in laparoscopic myomectomy surgery. Laparoscopic myomectomy is Gold Standard because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training of knotting and suturing. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically my Mishra's Knot.