This course will review and detail non-extirpative management of uterine fibroids. It will address the pros and cons of medical management, uterine artery embolization, high-frequency ultrasound, trans-cervical radiofrequency ablation, and laparoscopic radiofrequency ablation (RFA).  

The gynecologic procedures utilizing radiofrequency ablation will be covered in depth, with attention to surgical technique utilizing illustrations and videos demonstrating the technology, as well as proper versus suboptimal technique. Patient selection is crucial with RFA and will be directly discussed. Appropriate preoperative workup, patient counseling, the setting of expectations, and postoperative follow-up will be clearly presented. In addition, a breakdown of what clinical features constitute an easy, moderate, or difficult case will be outlined to clarify case selection. By targeting real issues, this course will broaden the knowledge base and advance the application of these highly useful but at times poorly understood modalities.

Learning Objectives: After attending this session, the participant will be able to: 1) Counsel patients appropriately regarding the benefits, drawbacks, and likely results of treatment of uterine fibroids using non-extirpative means; 2) Examine the advantages and disadvantages of medical management and the technologies of uterine artery embolization, high-frequency ultrasound, and trans-cervical and laparoscopic RFA and how the procedure(s) should be properly performed in order to maximize outcomes; and 3) Counsel patients effectively by routinely including these modalities as viable options along with standard extirpative procedures.

Presentations:
Welcome, Introduction and Course Overview

Medical Management of Fibroids
Catherine Lu, MD, University of Manitoba, Winnipeg, MB, Canada

Uterine Artery Embolization
James B. Spies, MD, MPH, Radiology, MedStar Georgetown University Hospital, Washington, DC

High Frequency Ultrasound
Elizabeth A. Stewart, MD, Mayo Clinic, Rochester, MN

Trans-Cervical RFA: The RF System, Key Clinical Studies, Setting Expectations and Patient Counseling (Pros/Cons)
Michelle Y. Louie, MD, MSCR, FACOG, Gynecologic Surgery, Mayo Clinic Arizona, Phoenix, AZ

Trans-Cervical RFA: Surgical Technique and Complication (what/why/prevention), Interesting Cases/Video Presentations
Kelley H. Rouse, MD, Charlotte OB/GYN, Charlotte, NC

Laparoscopic RFA: The RF System, Key Clinical Studies
Hillary A. Robinowitz-Elins, MD, Novant Health- Novant Huntersville Hospital, Mooresville, NC

Laparoscopic RFA: Setting Expectations and Patient Counseling
Soyini M. Hawkins, MD, MPH, FACOG, Northside Hospital, Norcross, GA

Laparoscopic RFA: Surgical Technique and Complications (what/why/prevention), Interesting Cases/Video Presentations
Bruce B. Lee, MD, FACOG, Obstetrics & Gynecology, Rox Surgery Center NB; Southern California Hospital of Culver City; Hoag Presbyterian Hospital Newport Beach, Newport Coast, CA

Discussion - Questions & Answers - All Faculty

Adjourn