The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic laser myomectomy.
Further recommendations have been made as part of the clinical guideline on heavy menstrual bleeding published in January 2007. Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. The IP guidance on Laparoscopic laser myomectomy disease remains current, and should be read in conjunction with the clinical guideline.
This procedure is used to treat uterine fibroids (leiomyomas).
Fibroids are benign tumours of the uterine muscle. They are very common. They may cause pain, heavy menstrual bleeding (menorrhagia) and reduced fertility.
Hysterectomy is the standard treatment for women with fibroids whose symptoms have not resolved with medical treatment. Laparoscopic myomectomy is the destruction of fibroids via a laparoscope passed through a small incision in the abdomen and then through the wall of the uterus. The fibroids may be destroyed with a laser or electrocautery.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.