58674 Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency

Name of the Procedure:

Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency

Summary

This minimally invasive surgical procedure involves using a laparoscope (a small camera) to view the interior of the abdomen and pelvis and ablate (destroy) uterine fibroids using radiofrequency energy, guided by intraoperative ultrasound. The procedure is designed to be precise and less invasive than traditional surgery.

Purpose

The procedure aims to treat uterine fibroids, which are non-cancerous growths in the uterus that often cause pain, heavy menstrual bleeding, and other symptoms. The goal is to reduce or eliminate fibroid-related symptoms, improve quality of life, and preserve the uterus.

Indications

This procedure is indicated for women who have:

• Symptomatic uterine fibroids that cause pain or heavy menstrual bleeding.
• Failed to respond to medical treatments.
• Desire to retain their uterus and avoid more invasive surgery.

Preparation

Before the procedure, patients may need to:

• Fast for several hours.
• Adjust or stop certain medications, as advised by their doctor.
• Undergo imaging tests such as an ultrasound or MRI to map out fibroids.
• Complete blood tests and assessments to ensure they are fit for surgery.

Procedure Description

1. The patient is given general anesthesia.
2. A small incision is made near the navel to insert the laparoscope.
3. Additional small incisions may be made for surgical instruments.
4. Intraoperative ultrasound is used to locate and assess the fibroids.
5. Radiofrequency energy is delivered to the fibroids via a special device, ablation them while preserving surrounding tissue.
6. The laparoscope and instruments are removed, and the incisions are closed with sutures.
7. The patient is monitored during recovery.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or outpatient surgical center.

Personnel

• Surgeon specialized in gynecologic laparoscopy
• Anesthesiologist
• Surgical nurses
• Ultrasound technicians

Risks and Complications

Common risks:

• Bleeding
• Infection
• Pain or discomfort at the incision sites

Rare risks:

• Injury to surrounding organs (bladder, bowel, or blood vessels)
• Reaction to anesthesia
• A need for open surgery if complications arise

Benefits

• Minimally invasive with smaller incisions and quicker recovery.
• Less postoperative pain compared to traditional surgery.
• Preserves the uterus, which may be important for women wishing to maintain fertility.

Recovery

• Post-procedure, patients usually recover in the surgical center for a few hours and can often go home the same day.
• Rest for a few days with gradual return to normal activities.
• Follow post-operative instructions, including wound care and activity restrictions.
• Follow-up appointments to monitor recovery and ensure effective treatment of fibroids.

Alternatives

• Medical treatments (e.g., hormonal therapy)
• Uterine artery embolization
• Myomectomy (surgical removal of fibroids)
• Hysterectomy (surgical removal of the uterus), which is more invasive and results in loss of fertility

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel pain. Post-procedure, they may experience mild pain or discomfort at the incision sites, which can be managed with pain medication. Most patients can resume normal activities within a few days but should allow for adequate rest and follow all medical advice for a smooth recovery.