Intraligamentous and broad ligament fibroid are difficult to remove due to risk of injury to ureter and uterine artery at the time of dissection. Following a thorough exposure of ureter and vessels and depending on the location of Myoma, an incision is made on the anterior or posterior leaf of the broad ligament and the leiomyomas is slowly shelled same as other subserosal or intramural fibroid.

Throughout the procedure the location of the ureter is monitored, bleeding points are controlled by bipolar. The broad ligament and peritoneum are not closed in cases of broad ligament Myoma. If post operative bleeding is suspected, a drain should be left. (less info)