CPT® Code 58674

Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency

Laparoscopy, surgical, ablation of uterine fibroid(s) is a minimally invasive procedure aimed at treating benign tumors known as uterine fibroids, which develop from the muscle tissue of the uterus (myometrium). These fibroids can vary in location and type: submucous fibroids extend into the uterine cavity, intramural fibroids are embedded within the uterine wall, and subserous fibroids are located on the outer surface of the uterus. The procedure utilizes radiofrequency ablation (RFA) technology, which is effective for fibroids of various sizes and locations. During the procedure, two small incisions are made—one in the infraumbilical region and another in the suprapubic region—to facilitate the insertion of laparoscopic instruments. Pneumoperitoneum, or the introduction of gas into the abdominal cavity, is established to create a working space for the surgeon. A thorough laparoscopic examination is conducted, often accompanied by intraoperative ultrasound, to accurately identify all fibroid tumors present. The RFA device is then introduced into the peritoneal cavity through a small incision, allowing for precise targeting of the fibroid. The procedure involves advancing the RFA tip into the fibroid, deploying an electrode array, and using laparoscopic visualization along with ultrasound guidance to ensure correct placement. Once the electrode array is activated, it heats to a predetermined target temperature, which is maintained for a specified duration to achieve complete ablation of the fibroid. After treating all identified fibroids, the RFA device is removed, the CO2 gas is evacuated from the peritoneal cavity, and the skin incisions are closed, resulting in minimal recovery time and reduced postoperative discomfort for the patient.