Acessa Procedure Doctors and Fibroids: What to Know

Acessa Procedure Doctors and Fibroids: What to Know

Uterine fibroids are common, benign tumors that can cause heavy bleeding, pelvic pressure, pain, and fertility challenges. If you have been told you have fibroids and want a uterus-sparing, minimally invasive option, you may have heard about the Acessa procedure—also called laparoscopic radiofrequency ablation (Lap-RFA). This guide explains how it works, who it helps, what to ask doctors, and how it compares to other treatments, drawing on trusted medical sources.

What is the Acessa procedure?

Acessa is a minimally invasive surgical technique that uses radiofrequency energy (heat) to treat fibroids from the inside. During laparoscopy, a surgeon inserts a thin probe into each targeted fibroid under ultrasound guidance. Controlled energy is delivered to ablate (destroy) fibroid tissue, which then shrinks over time. No large uterine incisions are made, and no fibroid tissue is removed from the body. Most patients go home the same day.

Clinically, Acessa is one form of radiofrequency ablation (RFA) for fibroids. The devices used for Lap-RFA are cleared by the U.S. Food and Drug Administration (FDA) via the 510(k) process, and the approach is recognized by professional organizations as a uterus-sparing option for appropriately selected patients.

Who is a good candidate?

Doctors may consider Acessa for people with symptomatic fibroids who want to avoid hysterectomy. It can address multiple fibroids and a range of locations, particularly intramural (within the uterine wall) and subserosal (outer-wall) fibroids. Suitability depends on your anatomy, the number, size, and location of fibroids, and your goals for future pregnancy.

You might be a candidate if you have:

  • Heavy menstrual bleeding that affects quality of life
  • Bulk symptoms (pelvic pressure, urinary frequency, abdominal distention)
  • Pain related to fibroids
  • An interest in uterine preservation and a short recovery

Patients with predominantly submucosal (cavity-distorting) fibroids may be better served by hysteroscopic procedures. Very large or pedunculated fibroids, extensive adenomyosis, or significant scar tissue can affect candidacy. A comprehensive evaluation with imaging—usually transvaginal ultrasound and sometimes MRI—helps map fibroids and guide recommendations.

Benefits to consider

  • Minimally invasive: Small incisions, typically outpatient, and return to light activity in days rather than weeks.
  • Uterus-sparing: Preserves the uterus and avoids the risks of tissue removal and power morcellation.
  • Symptom improvement: Studies show significant reduction in bleeding and bulk-related symptoms and improvements in quality of life for most patients in the short to mid-term.
  • Treats multiple fibroids: Surgeons can ablate several fibroids in one session.

Risks and limitations

All procedures have risks. With Lap-RFA these may include pain, bleeding, infection, injury to nearby organs, thermal injury, or adhesion formation. Some patients may need additional fibroid treatment in the future. Evidence on long-term durability continues to accumulate, and while pregnancies have been reported after RFA, professional societies note that data on fertility and pregnancy outcomes are still limited; some clinicians prefer myomectomy if future pregnancy is a high priority.

Acessa vs. other fibroid treatments

There is no single “best” treatment—choices should align with your symptoms, health, and goals. Options include:

  • Watchful waiting: For mild or improving symptoms.
  • Medications: Hormonal therapies (e.g., combined hormonal contraception, progestins, levonorgestrel IUD), GnRH agonists or antagonists, and tranexamic acid can reduce bleeding but do not eliminate fibroids.
  • Myomectomy: Surgical removal of fibroids (hysteroscopic, laparoscopic, or open). Effective for symptom relief and often preferred when pregnancy is desired, but involves larger incisions or uterine suturing and longer recovery than Lap-RFA.
  • Uterine artery embolization (UAE/UFE): Blocks blood supply to fibroids; improves bleeding and bulk symptoms. It is uterus-sparing but not typically recommended for those seeking pregnancy soon.
  • MR-guided focused ultrasound (MRgFUS): Nonincisional thermal ablation under MRI guidance; availability and candidacy vary.
  • Hysterectomy: Definitive cure for fibroids and bleeding; not suitable for those wishing to keep the uterus.

Discuss with your doctor how Acessa compares with these options in terms of symptom relief, recovery, complications, and reintervention rates based on your specific case.

How to choose an Acessa procedure doctor

Look for a board-certified OB-GYN or minimally invasive gynecologic surgeon (MIGS) with focused experience in fibroid care and Lap-RFA. Consider:

  • Experience and case volume with Acessa and other fibroid procedures
  • Use of intraoperative ultrasound for precise targeting
  • Availability of all major treatment options for unbiased counseling
  • Published or tracked outcomes, complication and reintervention rates
  • Comfort discussing fertility considerations and alternatives

Good questions to ask:

  • Am I a candidate for Acessa based on my imaging and symptoms? What are my other options?
  • How many Acessa procedures have you performed, and what outcomes have you seen in cases like mine?
  • What are the risks, possible need for future treatment, and expected recovery timeline?
  • How might this procedure affect future pregnancy?

What to expect before, during, and after

Before: Your doctor will review your history, perform a pelvic exam, and order imaging to map fibroids. If heavy bleeding has caused anemia, iron therapy or other optimization may be recommended. Depending on age and symptoms, an endometrial biopsy may be done to rule out other causes of bleeding.

During: Under general anesthesia, small incisions allow placement of a camera and instruments. Ultrasound guidance helps the surgeon place the RFA probe into each fibroid. Energy is delivered for a set time and temperature to ablate tissue safely. Most procedures take 1–2 hours.

After: Expect mild to moderate cramping, fatigue, or shoulder-tip pain from laparoscopy gas for a day or two. Light activity is often possible within a few days; many return to work in about a week depending on job demands. Symptom improvement tends to build over weeks to months as fibroids shrink. Your team will provide instructions on activity, pain control, and signs that should prompt a call.

Insurance, coding, and access

Most major insurers, including Medicare in many regions, may cover laparoscopic radiofrequency ablation for medically necessary fibroid treatment, but prior authorization is common. The CPT code often used in the U.S. is 58674 (laparoscopic ablation of uterine fibroids, including intraoperative ultrasound guidance and monitoring, radiofrequency). Ask your surgeon’s office to verify benefits and expected out-of-pocket costs in advance.

Key takeaways

  • Acessa (Lap-RFA) is a minimally invasive, uterus-sparing option that can reduce bleeding and bulk symptoms from fibroids with a relatively fast recovery.
  • It is one of several evidence-based treatments; the “best” choice depends on your symptoms, anatomy, and pregnancy goals.
  • Data on fertility after RFA are limited; if pregnancy is a priority, discuss myomectomy and other options.
  • Choose an experienced surgeon who offers multiple treatments and engages in shared decision-making.

Trusted resources

Disclaimer: This article is for educational purposes and does not replace personalized medical advice. Discuss the risks and benefits of each option with your healthcare provider.

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