Laparoscopic Use of the KTP/532 Laser in Nonendometriotic Pelvic Surgery

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Abstract
A major advantage of the KTP/532 laser in laparoscopic reproductive pelvic surgery is the ability to transmit the laser energy through a flexible fiber which can be easily directed at a lesion. It has recently been evaluated for the laparoscopic treatment of endometriosis. It has been theoretically suggested that the KTP/532 laser might not be useful in other laparoscopic operative procedures because the lack of tissue pigmentation would reduce the lesion's absorption of the visible wavelength beam and therefore decrease the laser's efficacy of destruction. This report describes application of the KTP/532 laser in laparoscopic pelvic surgery not involving endometriosis in 20 patients over a three-month period. Procedures performed laparoscopically with the KTP/532 laser were fimbrioplasty (4), pelvic adhesiolysis (10), and transection of the uterosacral ligaments (6). Of 14 patients undergoing laparoscopic surgery with a preoperative diagnosis of pelvic pain, 12 reported complete resolution of pelvic pain following laparoscopic KTP/532 laser surgery. There were no intraoperative or postoperative complications among these patients. With only a six-week follow-up period, none of the patients have conceived. We conclude that in addition to its use in the treatment of endometriosis, the KTP/532 laser fiberoptically transmitted by means of a laparoscope can be safety used to perform a wide variety of other pelvic surgical procedures. Its relative efficacy compared to other forms of laparoscopic operative techniques, the subsequent pregnancy rates of patients attempting to conceive, and its ability to ameliorate pelvic pain remains to be established.

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