Barut Ovgu, Terrazas Jose Luis
Obstetrics and Gynecology, Health Corporation of America Florida Northwest Hospital, Margate, USA.
Cureus. 2025 Apr 1;17(4):e81558. doi: 10.7759/cureus.81558. eCollection 2025 Apr.
Laparoscopic radiofrequency ablation (RFA) is a minimally-invasive technique to decrease the size of tumors using thermal energy to destroy tissue. Uterine leiomyomas are common conditions comprising benign smooth muscle tumors. Single-incision laparoscopic surgery is a modern surgical approach for allowing the removal of diseased organs through a small skin incision. We aim to demonstrate the feasibility and advantages of a single-site RFA for uterine leiomyomas, highlighting its potential to reduce operative time, minimize scarring, and improve patient recovery compared to traditional multi-port approaches. We present the case of a 46-year-old female patient who presented for scheduled RFA of a dominant 4.5 cm anterior myoma causing heavy menstrual bleeding. A uterine manipulator was introduced into the endometrial cavity. A single-site port was introduced into the abdomen and laparoscopic ultrasound was then performed revealing a 4.5 cm anterior myoma as well as a posterior myoma The anterior aspect of the fibroid was desiccated using an RFA probe set at 95°C for two minutes. The probe was then repositioned to the posterior aspect and desiccated in multiple locations until complete treatment was achieved. This case demonstrates the successful treatment of a 4.5 cm anterior uterine myoma and posterior fibroid using single-site RFA, resulting in minimal blood loss, reduced postoperative pain, and rapid recovery. The surgery was performed in a manner identical to traditional laparoscopic RFA with three ports. In addition to minimal blood loss, our single-site approach resulted in less incisional pain, less scarring, and better cosmesis. The patient was discharged on the same day and rapidly resumed her activities of daily living as assessed during her postoperative visit. Our case highlights the benefits of novelty in medicine with increased patient satisfaction regarding cosmesis. This technique has the potential to reduce costs by reducing operative time and facilitating a faster return to work for the patient. With appropriately selected patients, similar access to most myomas can be achieved.
腹腔镜射频消融术（RFA）是一种微创手术技术，利用热能破坏组织来减小肿瘤大小。子宫平滑肌瘤是常见的良性平滑肌肿瘤。单切口腹腔镜手术是一种现代手术方法，可通过一个小的皮肤切口切除患病器官。我们旨在证明单部位RFA治疗子宫平滑肌瘤的可行性和优势，强调其与传统多端口方法相比，有减少手术时间、最小化瘢痕形成以及改善患者恢复的潜力。我们报告一例46岁女性患者，因有一个导致月经过多的4.5cm前位肌瘤而前来接受预定的RFA治疗。将子宫操纵器置入子宫内膜腔。在腹部置入一个单部位端口，然后进行腹腔镜超声检查，发现一个4.5cm的前位肌瘤以及一个后位肌瘤。使用设置为95°C的RFA探头对肌瘤的前表面进行干燥处理两分钟。然后将探头重新定位到后表面，并在多个位置进行干燥处理，直至完成治疗。该病例证明了使用单部位RFA成功治疗了一个4.5cm的子宫前位肌瘤和后位肌瘤，导致失血极少、术后疼痛减轻且恢复迅速。该手术的操作方式与传统三端口腹腔镜RFA相同。除了失血极少外，我们的单部位方法还导致切口疼痛减轻、瘢痕形成减少且美容效果更好。患者在同一天出院，术后随访评估显示其迅速恢复了日常生活活动。我们的病例突出了医学创新的益处，患者对美容效果的满意度提高。该技术有可能通过减少手术时间和促进患者更快重返工作岗位来降低成本。对于适当选择的患者，可以实现对大多数肌瘤的类似入路。
