Energy-based platforms have been studied and used to treat uterine fibroids for more than 20 years. These efforts have led to the development of a wide range of minimally invasive devices to improve patient symptoms equivalent to or better than other traditional treatment methods, such as myomectomy or hysterectomy.
Thermal ablation devices treat the fibroid by heating the tissue. This heating is accomplished by converting energy, usually electrical or light, into intracellular mechanical energy that creates heat within the cells of the target tissue. This heating process causes necrosis of the target tissue, which causes the fibroid to shrink.
The idea of ablating fibroids with energy was originally referred to as myoma coagulation or myolysis. It was initially performed using a laser to deliver energy to the fibroid during laparoscopy or hysteroscopy. The procedure evolved when the bipolar radiofrequency needle electrode was developed. The bipolar electrode was initially used in 1993 by Gallinat and Lueken. However, while the laser and bipolar methodologies demonstrated good efficacy, they did not find widespread acceptance. There were concerns within the surgical community regarding postoperative complications due to adhesions, the time it took to complete the procedure and the ability to clearly identify the targeted tissue.
Recent developments of radiofrequency ablation (RFA) platforms, such as the Acessa System, have helped address these concerns. The Acessa Handpiece incorporates an electrode array, which creates a time and temperature-controlled zone of ablation. The size of the radiofrequency volumetric thermal ablation (RFVTA) is dependent on the size of the fibroid. At its simplest level, this electrical energy is used to create heat in the surrounding tissue and to destroy diseased cells. The heat is generated at 95 degrees Celsius for a specified amount of time, dependent on the fibroid size.
 S. Jones et al, Radiofrequency Ablation for Treatment of Symptomatic Uterine Fibroids, Obstetrics and Gynecology International, Volume 2012.