Laparoscopic fibroid Tx clips uterine arteries. (New Procedure: Little Data).

SCOTTSDALE, ARIZ. -- Gynecologists are looking toward clamping or clipping the uterine arteries--temporarily or permanently--as less painful alternatives to uterine artery embolization for the treatment of uterine fibroids.

Preliminary studies of the new procedures were presented as a means of reclaiming care of patients with fibroids from interventional radiologists, who perform uterine artery embolization (UAE), at an international congress on uterine fibroids sponsored by the American Association of Gynecologic Laparoscopists.

Presenters discussed two approaches: the laparoscopic attachment of a small vascular clip to the arteries, and the intravaginal placement of a larger, temporary clamp on the arteries.

The laparoscopic procedure has been performed in approximately 2,000 cases worldwide, according to one estimate, yet only five small case series have been published on it. The intravaginal approach is not nearly as well researched but is being investigated in feasibility studies. The potential advantage of this method is that, unlike the laparoscopic procedure, it would not involve surgery.

Since UAE became popular for fibroid treatment in the late 1990s, gynecologists have complained about being left to care for complications of embolizations performed by the interventional radiologists.

Laparoscopic occlusion of uterine arteries has several advantages over embolization, said Dr. Kirsten Hald of Ullevaal University Hospital, Oslo, Norway.

With uterine artery occlusion, gynecologists who perform laparoscopy can diagnose and address other diseases they may find while treating fibroids, and they won't need to acquire the specialized equipment required to perform UAE. Gynecologists also can care for patients from diagnosis of the fibroids through treatment and follow-up.