Percutaneous laser-induced interstitial thermotherapy (LITT) for the treatment of very large uterine leiomyomas

The success of treating tumours of tile liver under local anaesthesia and ultrasound and computered tomography control by means of the diode laser of 810nm wavelength with fibre splitter and multiple fibres suggested this form of LITT might be suitable for the treatment of very large leiomyomas where laparoscopy was not possible. The immediate effect of LITT was to produce a large volume of coagulation within the myomas, to destroy the oestrogen receptors and to coagulate the surrounding blood vessels. After one month tile coagulated volume had been converted into a jelly-like substance (Figure 1) and the zone surrounding this had started to degenerate because of the destruction of its blood vessels which had resulted in local tissue anoxia. Three months later the central coagulum and surrounding zone had been partially absorbed and the whole volume of myoma treated had shrunk to a quarter of the original size. lt has thus been shown that a minimally invasive method for the destruction of very large uterine leiomyomas can be safely performed but further research is required before its general adoption.