CO2 Laser Laparoscopy in Tubo-Ovarian Infertility
Since 1985, more than 500 CO2 laser laparoscopic procedures have been done, including treatment of endometriosis, adhesiolysis, salpingo-ovariolysis and salpingoneostomy. The most frequent indication was endometriosis. The results were as follows. Endometriosis: 85 patients total. In AFS Stage 1-2: 17/30 (57%) ongoing pregnancies; AFS Stage 3:18/37 (48%) ongoing pregnancies; and AFS Stage 4: 6/16 (38%) ongoing pregnancies. Adhesiolysis: Degree I, 76 patients with 51 (65%) ongoing pregnancies. Degree II, 84 patients with 41 (50%) pregnancies. Fimbrioplasty: 63 patients with 40 (64%) ongoing pregnancies, and 3 women developed ectopic pregnancies. Salpingoneostomy: 43 patients with 10 (20%) ongoing pregnancies and 2 women with ectopic pregnancies. These results are equivalent to microsurgical ones. For the last 150 operations, the new ultrapulse 500 L (Coherent) laser has been used and appeared to produce less tissue damage. No major complications. In conclusion, laparoscopic surgery with CO2 laser appears at least as effective as microsurgery for patients suffering from infertility.
Dequesne
JG
Endoscopic Center Clinique Cecil, 6, ch. des Croix-Rouges, CH-1007 Lausanne, Switzerland.