New therapeutic technique for treatment of uterine leiomyomas using laser-induced interstitial thermotherapy (LITT) by a minimally invasive method

BACKGROUND AND OBJECTIVE: This study was undertaken to see if uterine leiomyomas would respond to LITT, as had certain other tumours, and leave behind a uterus capable of child bearing. STUDY DESIGN/MATERIALS AND METHODS: Preliminary research to determine laser power and energy requirements to coagulate leiomyomas was carried out on such tumours at the time of myomectomy or hysterectomy. The information gleaned permitted subsequent volunteer patients to be treated by a minimally invasive route. LITT was employed to treat 300 patients, 293 of them with the KTP/YAG laser with a bare fibre laparoscopically or through the hysteroscope. The remaining seven were treated with the Diode laser, five of them being treated percutaneously with fibre splitter and four fibres. RESULTS: Symptomatic patients (300) with 950 myomas between them were treated. Follow-up has been between 6 months and 6 years. No significant complications occurred, and the procedure(s) were successful in 294 patients. CONCLUSIONS: It is the treatment of choice for those leiomyomas that are difficult to remove because of their size or position. Fertility is enhanced, oestrogen receptors and epidermal growth factor are destroyed, and healing occurs without scarring.