We offer several treatment options for fibroid removal including Laparoscopic Radiofrequency Ablation (Lap-RFA), a procedure for pre-menopausal women (typically younger than 55 years old) who are experiencing ongoing pain and discomfort of fibroids and are looking for a minimally invasive option that allows them to keep their uterus and return to daily life quickly after the procedure.
How the procedure works:
- The clinical terminology for the procedure is Laparoscopic radiofrequency ablation (Lap RFA) for fibroids.
- The Acessa procedure typically takes between 90 to 120 minutes depending on the size, location, and number of fibroids.
- Fibroids are heated, using radiofrequency ablation, to the point where they are destroyed and are no longer the consistency of a fibroid. The heat denatures the proteins inside the fibroid cells.
- After being heated they go from the consistency of a hard baseball to a soft marshmallow.
- The change in the consistency to a soft marshmallow and gradual shrinkage is what creates the relief from the fibroid symptoms.
- When the heated tissue shrinks into the marshmallow the reduced cells typically get recycled into the body. This is the same natural process the body uses when recovering from a scab.
- There is no incision within the uterus which allows the physician to spare the healthy tissue.
- This procedure can also be used in conjunction with other procedures such as a myomectomy and endometrial ablation.
What size and types of fibroids can be treated through Lap-RFA?
Size and location of fibroids are important factors in what procedure is right for you. An MRI or ultrasound will be performed to determine if you are a candidate for the procedure.
The Acessa procedure has been studied on fibroids up to 10cm, commercially physicians have treated larger fibroids. The procedure is not recommended for pedunculated fibroids (fibroids on a stalk).
How does Lap-RFA compare to other treatment options?
Vs. Hysterectomy — Acessa keeps your uterus and has a quicker recovery and fewer scars. However, hysterectomy is a definitive treatment, so after recovery there is no chance fibroid symptoms will return.
Vs. Myomectomy — Acessa is typically considered less invasive than a myomectomy, even a robotic myomectomy, because there is less blood loss during the procedure, less scars and no cutting and suturing of uterine tissue. Also, for patients with multiple, small fibroids, physicians often note that Acessa can be a more accurate procedure because it utilizes an ultrasound to find and target fibroids whereas during most myomectomies the surgeon is only using his or her eyes. However, because myomectomies remove the fibroid right away, patients with larger fibroids may experience quicker relief from bulking than with Acessa, which can take longer to shrink fibroids.
Vs. UAE — Acessa is typically considered by gynecologists a less invasive procedure than UAE because it does not require an overnight stay in the hospital and typically patients report less post-operative pain. However, Acessa does require general anesthesia and incisions in the abdomen, whereas UAE does not always require anesthesia nor a visible incision.
Vs. Hysteroscopic options (GEA, hysteroscopic myomectomy, transcervial RFA) — Acessa is typically considered a more comprehensive treatment option for fibroids because the procedure is performed laparoscopically, through the stomach, vs. through the cervix, which allows surgeons to target fibroids all around the uterus. Hysteroscopic options can be quicker and comprehensive for patients with fibroids that are closer to or in the uterine cavity.
Is Lap-RFA safe?
Patients who are determined as candidates for the procedure should discuss risks, benefits, and insurance coverage with their provider.
Are there external scars?
There are three incisions, one in the belly button, which typically does not leave a scar, one above the bikini line, and one small incision that does not typically leave a scar by the bikini line.
I’m interested, what’s next?
Schedule an appointment today! If you are traveling from out of town, ask us about our tele-consult options.