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Bevan Exemplar Cohort 7 Projects

Sonata; incisionless fibroid surgery in outpatients

Anthony Griffiths

Cardiff and Vale University Health Board

The Project:

A new approach to the treatment of patients with uterine fibroids that improves the patient experience, while taking pressure off theatres and inpatient beds.

The Sonata system is an innovative alternative treatment for benign uterine fibroids that would otherwise require an invasive procedure such as hysterectomy or uterine arterial embolisation (UAE). The Sonata Treatment uses real-time guided transcervical ultrasound and radiofrequency energy to shrink the fibroid and reduce symptoms without the need for any incisional intervention. The treatment is a short minimally invasive procedure, performed under local anaesthetic, with no requirement for an overnight stay.

How this will be achieved:

University Hospital of Wales plan to use its established outpatient operating environment to introduce Sonata as an outpatient therapy for the treatment of fibroids. The procedure typically takes less than 30 mins and patients can return home any time from 30 mins onwards. Clinically suitable patients will be identified either from the current waiting list for treatment or from gynaecology outpatients.

Anticipated benefits:

Compared with the more invasive treatment options such as hysterectomy and UAE, patients are expected to benefit in the following way:

  • Reduced waiting time for treatment
  • Have an effective treatment option that preserves the uterus and fertility
  • Enables access to an effective, minimally invasive treatment option for a wider group of patients who would previously have been limited in their treatment options
  • Minimal post-procedural pain and recovery time
  • Improved patient experience

Benefits for the NHS Wales are expected to include:

  • Releases inpatient bed capacity – No overnight stay required
  • Releases theatre capacity – The Sonata procedure can be performed in an outpatient/ambulatory setting under a local anaesthetic.
  • Reduces readmissions associated with complications from treatment
  • Releases outpatient appointment capacity associated with follow-up apppointments