Dr. Dee-Dee Shiller Maryland Fibroids Specialist

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.

This procedure is designed to fit busy lives. The procedure is done outpatient and the patient may go home that evening.

Size and location of fibroids are important factors in what procedure 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).

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.

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.

The Acessa procedure is FDA cleared since 2012. There have been multiple clinical studies with a combined over 750 patients studied. Acessa Health Inc. reports over 3,000 cases performed to date.

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