New Directions in Fibroid Treatment: The Acessa Guidance System
Fibroids have just become easier to treat. Why? Because a new application for an old technology has given practitioners of radiofrequency ablation the ability to target them with unprecedented precision.
Earlier this year, Acessa Health (the company behind Acessa Procedure), introduced the Acessa Guidance System¹. Developed as a supplement to the existing Acessa System, Guidance leverages electromagnetic tracking technology to provide precise fibroid targeting capabilities. In simple terms, it’s like a GPS system for the uterus.
How The Acessa Guidance System Works
Acessa Procedure, a minimally invasive method of treating fibroids that’s also known as radiofrequency ablation, treats symptomatic uterine fibroids laparoscopically, without harming the healthy uterine tissue that surrounds them. The procedure involves an instrument known as the Acessa handpiece, which applies focused radiofrequency energy directly to the fibroid, destroying the fibroid with heat (a process known as “ablation”). The Guidance component adds an electromagnetic tracking function to the handpiece, which, when coupled with ultrasound, provides a real-time view on the device’s trajectory to the targeted fibroid.
A Novel Use For Tried-and-True Technology
Electromagnetic tracking technology is not new. However, until the release of Acessa Guidance, the technology had never been applied in the field of gynecology. This application helps overcome a longstanding challenge in treating fibroids: efficiently accessing small and hard-to reach fibroids.
Historically, gynecologic surgeons have identified fibroids through pre-operative imaging. A variety of imaging techniques – including transvaginal ultrasound, sonohysterography, MRI, and diagnostic hysteroscopy – can be used to provide surgeons with a snapshot of the existing fibroid tumors. While they vary in cost and convenience, the fibroid imaging techniques have one thing in common: the images they generate are static.
Typically, surgeons use reference images to determine how to best reach the fibroid during surgery. In real time, however, movement can occur that makes a certain fibroid inaccessible by a path that appeared clear in the reference image. In the context of the previous analogy that likened Acessa Guidance to GPS, a reference image is the functional equivalent of a printed map.
In a recently published feasibility study, gynecologic surgeon Dr. Don Galen explains, “reference images…do not provide real-time, intraoperative findings. Lack of real-time imaging is especially problematic for the surgeon if the patient has symptomatic intramural fibroids or intramural fibroids abutting—but not distorting—the endometrium.”
Before its introduction to gynecology, electromagnetic tracking technology had already proven its value in other medical applications. Image guidance systems have been widely adopted for use in neurosurgical, hepatobiliary, and endoscopic procedures, among others, with positive results. Referring to a study of the technology’s application in hepatobiliary surgery, the Galen study noted: “These surgeons tested their ability, time, and mental workload when targeting the analog tumor under different controlled conditions. The guidance system significantly reduced the number of required needle withdrawals and repositionings, and…their mental workload.”
Guidance For Treating Fibroids
Galen has seen similarly positive results since the technology has been incorporated into the Acessa System to help with the targeting of fibroid tumors. He found the dynamic animation to be helpful in the process of targeting each fibroid, reaching the fibroid quickly, and visualizing the positions of the transducer and handpiece within the pelvic cavity during surgery. The feasibility study concludes:
Its significant application is in the targeting of those fibroids not readily visualized on laparoscopy (such as intramural fibroids) prior to ablation… Consequently, any technology that facilitates the targeting and treating of otherwise hard-to-reach fibroids is of benefit to the gynecologic surgeon as well as to the patient’s wellbeing.
With powerful image guidance technology enhancing an advanced, minimally invasive fibroid treatment procedure, treatment for fibroids is clearly moving in the right direction.
¹Patented AIM™ guidance software provided by InnerOptic Technology, Inc.
Galen, D. “Electromagnetic image guidance in gynecology: prospective study of a new laparoscopic imaging and targeting technique for the treatment of symptomatic uterine fibroids”, BioMedical Engineering Online. Oct. 2015; 14:90.
“Halt Medical, Inc. Announces The First Acquisition Of Acessa Guidance System”, PR Newswire. June 27, 2016.
Metson, R. “The Role Of Image Guidance Systems for Head and Neck Surgery”, JAMA Otolaryngology. Oct. 1999; 125(10): 1100-1104