Canadian Experience with Acessa ProVu: A Case Series of the First 60 Laparoscopic Radiofrequency Fibroid Ablation Procedures at a Single Centre

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OBJECTIVE: (s): Laparoscopic radiofrequency ablation (Lap-RFA) is a minimally invasive procedure for reducing fibroid size; however, most published studies primarily focus on fibroids ≤7 cm. We describe the first Canadian case series of ultrasound-guided Lap-RFA for symptomatic fibroids, including treatment of fibroids up to 10 cm. METHODS: In this retrospective case series, an analysis was performed of consecutive ultrasound-guided Lap-RFA cases for the management of symptomatic fibroids from September 15, 2022 to May 13, 2024. The primary outcome was fibroid volume reduction at 3, 6 and 12 months postoperatively. Secondary outcomes included operative time, length of postoperative recovery stay (LOS), urgent care visits, reinterventions and subsequent pregnancies. RESULTS: at 12 months, a difference of 39.7%, 38.9% and 43.6% respectively (P < 0.01). Two patients had postoperative urgent care visits and one underwent reintervention. Three patients (5%) conceived a median of 141 days (IQR 74-268) postoperatively, all delivered at term. CONCLUSION: (s): In this case series, we observed similar volume reductions as in the literature, even for fibroids 7-10 cm in size. Further studies incorporating validated patient-reported outcome measures are needed to better correlate objective outcomes with patient-reported improvement.

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