Background: Uterine fibroids occur singly or as multiple benign tumors originating\nin the myometrium. Because they vary in size and location, the approach and technique\nfor their identification and surgical management vary. Reference images, such as\nultrasound images, magnetic resonance images, and sonohystograms, do not provide\nreal-time intraoperative findings.\nMethods: Electromagnetic image guidance, as incorporated in the Acessa Guidance\nSystem, has been cleared by the FDA to facilitate targeting and ablation of\nuterine fibroids during laparoscopic surgery. This is the first feasibility study to verify\nthe features and usefulness of the guidance system in targeting symptomatic uterine\nfibroidsââ?¬â?particularly hard-to-reach intramural fibroids and those abutting the endometrium.\nOne gynecologic surgeon, who had extensive prior experience in laparoscopic\nultrasound-guided identification of fibroids, treated five women with symptomatic\nuterine fibroids using the Acessa Guidance System. The surgeon evaluated the\nsystem and its features in terms of responses to prescribed statements; the responses\nwere analyzed prospectively.\nResults: The surgeon strongly agreed (96 %) or agreed (4 %) with statements describing\nthe helpfulness of the transducer and hand pieceââ?¬â?¢s dynamic animation in targeting\neach fibroid, reaching the fibroid quickly, visualizing the positions of the transducer and\nhandpiece within the pelvic cavity, and providing the surgeon with confidence when\ntargeting the fibroid even during ââ?¬Å?out-of-planeââ?¬Â positioning of the handpiece.\nConclusions: The surgeonââ?¬â?¢s positive user experience was evident in the guidance\nsystemââ?¬â?¢s facilitation of accurate handpiece tip placement during targeting and ablation\nof uterine fibroids. Continued study of electromagnetic image guidance in the laparoscopic\nidentification and treatment of fibroids is warranted.
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