Directed laparoscopic cryomyolysis: A possible alternative to myomectomy and/or hysterectomy for symptomatic leiomyomas

Objective: The purpose of this study was to develop a minimally invasive, safe, and effective technique for managing symptomatic uterine myomas. Study design: Twenty patients with symptomatic uterine fibroids were treated. All had complaints of abnormal bleeding and/or pelvic pain/pressure and/or urinary frequency. Myoma diameters were 4 to 8 cm. Power color Doppler imaging was performed preoperatively and postoperatively to determine the effectiveness of cryomyolysis in reducing or eliminating the primary blood supply, as well as regression of the myomas. Laparoscopic cryomyolysis was performed with use of the Her Option Cryoablation System (American Medical Systems Gynecology, San Diego, Calif). Patients were evaluated at 1, 3, and 6 months postoperatively. Results: All patients were discharged within 24 hours of treatment. No intraoperative or postoperative complications occurred. Of the 20 patients treated, 19 had complete resolution of their complaints. Myomas regressed up to 80%, and major blood supply to the myomas was eliminated. Conclusion: Directed laparoscopic cryomyolysis is an effective and safe technique for symptom relief from leiomyomas. © 2004 Elsevier Inc. All rights reserved.