Radiofrequency Ablation (Acessa and Sonata)

The University of Chicago Medicine is one of few medical centers nationwide offering radiofrequency ablation of fibroids. Two fibroid ablation procedures are available for eligible patients: Acessa and Sonata.

How Acessa Works

Acessa, also known as laparoscopic radiofrequency ablation (Lap-RFA), is an outpatient procedure that destroys living fibroid tissue using a thin radiofrequency needle. During this procedure, the surgeon makes two small incisions in the abdomen and uses a needle to target and dehydrate fibroid tissue with radiofrequency energy (heat). Later, the body’s natural process gradually reabsorbs the fibroid into surrounding tissue in the uterus.

Acessa is performed under general anesthesia. Patients typically return to normal activities within a week.

How Sonata Works

Sonata, also known as transcervical fibroid ablation (TFA), is an outpatient procedure that destroys fibroids without incisions. Sonata uses the same type of radiofrequency energy as Acessa to heat and shrink fibroids, but with a different point of entry into the body. During the Sonata procedure, a gynecologic surgeon inserts a small device through the vagina and into the uterus. The device sends radiofrequency energy to the fibroid, causing it to shrink over time.

Sonata is performed under general or regional anesthesia and conscious sedation. Patients typically return to their normal activities in two to three days.

Alternative to Radiofrequency Ablation

Fibroid ablation procedures like Acessa and Sonata enable some patients to keep their uterus and obtain relief from their symptoms without a larger surgery. It is important to know that depending on the size and location of your fibroid, Acessa or Sonata may not be an appropriate option for you.

For patients who desire to maintain their fertility, we recommend myomectomy because the effects of fibroid ablation procedures like Acessa and Sonata on future pregnancy are unknown.

At a Glance: Fibroid Ablation (Acessa or Sonata) vs. Minimally Invasive Myomectomy

Doctor
Acessa Performed by gynecologic surgeon	Sonata Performed by gynecologic surgeon	Minimally Invasive Myomectomy Performed by gynecologic surgeon
Surgical or Nonsurgical
Acessa Requires small incisions in the abdomen	Sonata Does not require incisions in the abdomen; surgeon performs the procedure through the vagina	Minimally Invasive Myomectomy Does not require incisions in the abdomen if performed via hysteroscope; requires small incisions if performed robotically or laparoscopically
Anesthesia
Acessa General anesthesia	Sonata General or regional anesthesia and conscious sedation	Minimally Invasive Myomectomy General anesthesia
How It Works
Acessa Shrinks fibroids by using controlled heat to destroy fibroid tissue; preserves the uterus	Sonata Shrinks fibroids by using controlled heat to destroy fibroid tissue; preserves the uterus	Minimally Invasive Myomectomy Removes fibroids surgically; preserves the uterus
Inpatient or Outpatient
Acessa Patients usually go home the same day	Sonata Patients usually go home the same day	Minimally Invasive Myomectomy Patients usually go home the same day after hysteroscopic and most laparoscopic or robotic myomectomies
Recovery
Acessa Quick recovery (less than a week)	Sonata Quick recovery (two to three days)	Minimally Invasive Myomectomy Quick recovery (less than a week for hysteroscopy; up to two weeks for laparoscopy or robotic)
Pregnancy and Fertility
Acessa Effects on future pregnancy are uncertain	Sonata Effects on future pregnancy are uncertain	Minimally Invasive Myomectomy Option for patients desiring future pregnancy