Susan Khalil, MD, discusses staged uterine artery embolization for symptomatic uterine fibroids

Susan Khalil, MD, assistant professor at the Icahn School of Medicine at Mount Sinai and program director for the minimally invasive gynecologic surgery fellowship at Mount Sinai Hospital, discussed research presented at the 2025 ACOG Annual Clinical and Scientific Meeting exploring the use of staged uterine artery embolization to improve feasibility and outcomes in minimally invasive hysterectomy.

Khalil emphasized that large uterine fibroids can complicate hysterectomy procedures by reducing visibility and increasing the risk of morbidity. “Patient safety is going to come first, and sometimes large uterine fibroid size can also just limit visibility, can increase chances of having additional things that can add to morbidity,” she said.

The study examined the role of preoperative uterine artery embolization as a strategy to optimize surgical planning. “Performing [the procedure] in the safest way that lets the patient live a healthy life is critical,” Khalil said, noting that the approach aligns with trends in minimally invasive surgery and reflects over a decade of practice patterns covered in the study period.

Khalil explained that while imaging and clinical exams offer estimates of uterine weight, accurate assessment is often retrospective. Nonetheless, size is a key factor in predicting surgical complexity. “I think this can help with clinical decision making and clinical surgical decision making with ways to optimize patient safety, ways to reduce blood loss, and ways to enhance the feasibility of accomplishing hysterectomy with lower morbidity,” she said.

She identified 3 key takeaways from the research:

1. Staged uterine artery embolization can improve the feasibility of minimally invasive hysterectomy.
2. There are multiple mechanisms to reduce intraoperative blood loss.
3. The approach may also help reduce patient hospital stays and improve postoperative outcomes.

Khalil also called for greater investment in research infrastructure to support innovation in surgical care. “There are a lot of surgical techniques and advances in surgical innovation for women’s health care, and they really require great infrastructure for research to accelerate this phase,” she said.

Disclosure:

Advisory Committee/Board Member; Self; Consultant; Self.

Reference:

Ofori-Dankwa Z, O’Keefe RJ, Parisi K, Renirie R, Khalil SS, Behbehani S. Staged Uterine Artery Embolization Prior to Hysterectomy for Symptomatic Uterine Fibroids: A Narrative Synthesis [ID 993]. Obstetrics & Gynecology 145(6S):p 30S, June 2025. doi:10.1097/AOG.0000000000005917.002