Can laparoscopic myomectomy (traditional or robotic) be done under regional anesthesia? i read it's possible but some drs insist it needs general.

No way.: Laparoscopic myomectomy requires general anesthesia. The pressure and amount of carbon dioxide gas required to perform laparoscopy causes way too much pain to be done with a regional (epidural or spinal) anesthetic. A myomectomy is (usually, unless the fibroid is growing off a thin stalk) a more technically difficult procedure & requires the pt to in a position that needs full general anesthesia.

Probably not: If you're having an abdominal myomectomy, you will probably need to have your abdomen inflated so the surgeon can see all internal organs and manipulate tools to perform the surgery easily and safely. These type of surgeries require general anesthesia only. If you're having a myomectomy through the uterus however, these are sometimes done under spinal anesthesia safely.

Not typical: It is possible to do such a procedure using a spinal or epidural anesthetic, but this is really unusual, especially given the likely length and difficulty of a procedure such as a laparoscopic myomectomy. With your belly distended with air, you will still be uncomfortable, and the added sedation will add risk as far as your airway and risk of aspiration - does not sound like a good idea!

Possible, but...: While regional anesthesia is possible for abdominal surgeries, there are several obstacles to this plan. The biggest of which is that usually they willneed to inflate your abdomen with carbon dioxide, and breathing against this pressure without the assistance of a ventilator is usually cause enough to not attempt regional anesthesia, because a regional anesthetic weakens the muscles of breathing.

Comfort & Safety: Are key. Surgery involves traction on internal organs that may produce discomfort high up in the abdomen. A regional anesthetic that extends high enough to assure your comfort may also create breathing difficulties for you. Also, the co2 in your abdomen that facilitates surgery may further compromise your breathing. So, most surgeons/anesthesiologists will prefer ga for this procedure. No worries!

I agree...: I would insist on a general. A traditional open myomectomy (meaning abdominal incision) can be done under regional. Myomectomy performed laparoscopically and especially robotically needs to be performed under a general anesthetic. In my opinion, it is nearly impossible to keep a patient comfortable with this particular surgical technique under regional.