FIBROIDS: THE ACESSA PROCEDURE
Animated video about procedure:
Who is this procedure for?
This procedure is for pre-menopausal women (typically younger than 55 years old) who are tired of living with the 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 big of fibroids can Acessa treat? What types of fibroids can Acessa treat?
Size and location of fibroids are important factors in what procedures is right for you. That's why physicians do a MRI or ultrasound prior to determining 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 Acessa compare to other treatment options?
Vs. Hysterectomy – Acessa keeps your uterus and has a quicker recover and less 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 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 as visible incisions
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, however, hysteroscopic options can be quicker and comprehensive for patients which fibroids that are closer to or in the uterine cavity
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 issue.
- This procedure can also be used in conjunction with other procedures such as a myomectomy and endometrial ablation.
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
If the fibroids are not physically removed, how does Acessa work?
As a reminder, Acessa is a treatment for benign (non-cancerous) symptomatic fibroids. If patients are at risk for cancer, or malignancy, Acessa is not the appropriate treatment.
Studies show that fibroids do not have to be completely removed to solve symptoms.(1) Killing the fibroid cells so they shrink and stop putting pressure on the uterus can solve symptoms. Physicians have explained that even a fractional reduction in fibroid volume can result in significant improvement in heavy periods, pelvic pain and bulk. (1,2)
To summarize, Acessa works by heating the fibroid cells from the inside out, not by removing the fibroid. Cell tissues die when they reach a certain temperature. Acessa heats the fibroid tissue to the point that it dies. The dead fibroid tissue shrinks and shrivels. The dead fibroid tissue is not harmful. It gets absorbed by the body, just like any dead tissue cell.(2,3)
The Acessa Procedure - Results
- Addresses nearly all symptoms such as excessive bleeding, prolonged periods, urinary frequency, painful sex, stomach, lower-back and pelvic pain. Individual results vary based.
- In clinical studies, there was an average shrinkage of 45% in fibroid size post-procedure. This number is contingent on where the fibroids is located and the size.
- Women typically see the most symptom improvement within 3 months of the procedure with continued improvement throughout the first year.
- Studies have shown both clinically and statistically significant reduction in period blood loss.
- Significant reduction in fibroid and uterine volume.
- BY THE NUMBERS:
- 82% of women had lighter periods.
- 94% patient satisfaction rate
- Only 11% of patienst required additional reintervention after the Acessa procedure.
Why haven't I heard of Acessa before? Is it brand new?
Laparoscopic RFA was first performed on fibroids in 1999 by Dr. Bruce Lee. (2) After many successful studies, the original Acessa System was FDA cleared in November 2012. Since 2012, physicians have performed over 3,000 procedures to date.(5) The newest, most advanced technology, the Acessa ProVu system, was FDA cleared in 2018.
Your physician can explain the potential complications of the Acessa Procedure, as well as those of other available fibroid therapies.
Is it covered by insurance?
Acessa is covered by many insurance carriers. The first step if you are interested in Acessa is to contact a physician who offers Acessa and schedule an initial consultation. After you have a consultation with a physician and determine if you are a candidate for the procedure, they can help you understand the benefits and coverage for Acessa.
Acessa Health does not make any recommendations, referrals, or endorsements regarding specific physicians with whom patients may seek treatment, nor does this site serve as a tool for verification of a specific surgeon's credentials, qualifications, or abilities. Only a trained physician is qualified to recommend treatments and/or make diagnoses. You assume full responsibility for your communications and interactions made with any physician you choose to contact from the use of this website.
RISK STATEMENT: Acessa is cleared by the FDA for the treatment of symptomatic uterine fibroids. There are risks associated with all minimally invasive surgical procedures, including serious complications such as infection, bowel injury, and postoperative bleeding. Insufficient data exist on which to evaluate the safety and effectiveness of Acessa procedure in women who plan future pregnancy. Therefore, the Acessa procedure is not recommended for women who are planning future prengnancy. Please consult with an Acessa-trained gynecologist to understand the risks of surgery and find out if Acessa may be right for you.