Laparoscopic Uterine Artery Ligation (LUAL)

Five million women between the ages of 20 and 49 will experience the symptoms of fibroids including abnormal uterine bleeding and associated pain.

For unknown reasons, fibroids are diagnosed in black women two to three times more frequently than in white women, and fibroids account for about twice the number of hysterectomies among black women than among white women, according to the CDC.

About 200,000 hysterectomies each year are performed in the United States to treat fibroids.

Laparoscopic Uterine Artery Ligation (LUAL) is quickly becoming an exciting option for the treatment of fibroid tumors. The minimally invasive, virtually bloodless, and painless procedure is performed through three to four tiny surgical ports located in the abdomen and belly button. Through careful dissection by a qualified laparoscopic surgeon the arteries that supply blood to the uterus are identified and a clip is placed on each artery. An important factor in the meticulous placement of the clips is that they are designed to dramatically reduce, but not totally restrict, blood flow to the uterus placing the fibroids in a dormant or non-active state.

The rationale behind this technique is that blood delivered by the uterine arteries feeds and infuses the fibroids allowing them to be active and grow. If, however, blood flow is reduced but not totally restricted, the fibroids still continue to live, but not thrive, thereby diminishing symptoms including excessive pain and bleeding.

LUAL is superior to Uterine Artery Embolization (UAE) for the treatment of uterine fibroids.

UAE is a procedure performed by interventional radiologists in which a catheter is threaded through the groin into the femoral artery accessing the uterine arteries. The embolizing substance is delivered that blocks the blood supply to the fibroids. This procedure is performed by interventional radiologists.

The drawbacks of UAE include post procedural pain due to necrotic (dead ) tissue caused by totally cutting off blood supply to the fibroids and/or the uterus; less frequently, peritonitis (an inflammation of the membrane that lines the wall of the abdomen) and septicemia (presence of bacteria in the blood) occurs due to necrotic uterine tissue; menopause may occur due to blockage of blood supply to the ovaries; expense of the procedure and the need for specialized equipment; procedure performed by an interventional radiologist (IR) who doesn’t treat post procedural gynecologic complications; non-comprehensive treatment as an IR can’t diagnose and address other diseases they may find while treating fibroids.

In addition to dramatically less post-procedural pain, LUAL provides a complete and direct view of the pelvis during the procedure allowing for additional pathology to be addressed immediately.

Learn more about fibroids or persistent bleeding.