Microwave Thermal Ablation of Uterine Fibroids during Laparoscopic Surgery for Endometriosis

Abstract

Endometriosis is defined as the presence of endometrial glands or stroma outside the uterus, commonly diagnosed in women of childbearing age frequently with subfertility. Endometriosis is associated with the presence of uterine fibroids, which are benign tumors of the smooth muscle cells of the uterus, in 20-25% of cases. It is unclear whether fibroids interfere with fertility and pregnancy. The association of the two pathologies makes us ask the question of which is the best therapy to use. Sometimes medical therapy is not effective or has contraindications, surgery can be burdened with secondary effects that can impair fertility. In recent years, new techniques have been introduced to integrate conventional therapies, which involve the use of different forms of energy. Among these energies, an important place is occupied by microwaves (MW). MW creates an electromagnetic field that transforms kinetic energy into heat that induces cell death by coagulation necrosis. We have chosen to use MW thermal ablation to treat fibroids during laparoscopic surgery for endometriosis due to the fact that laparoscopic removal of myomas significantly lengthens the surgical time and increases possible complications.