The size and location of the incision will depend on the size and number of fibroids you have.  The abdominal approach is usually reserved for patients with a large number of fibroids, or very large fibroids.  The advantages of the Abdominal myomectomy in this setting is that it allows the surgeon the ability to actually feel the uterus and allows the surgeon to find fibroids deep inside the uterus that may not be visible just by looking.  The disadvantages are a longer hospital stay, longer recovery period,greater risk of blood loss, and pain.  Patents typically require a 48 to 72 hour hospital stay.