Treatment of gynecological diseases with microwave during laparoscopy

Objective: To evaluate the treatment of gynecological diseases with microwave during laparoscopy Methods: From May 1990 to March 1995, 240 cases with gynecological diseases were treated with microwave under laparoscopy using specially designed tips. Cases include endometriosis 193, ovarian cysts 41, hydrosalpinx 10, tubal pregnancies 8 and subserous myoma of uterus 3. Operations were all performed under combined local anesthesia, intravenous dolantin and sublingual dihydroectorphine, infiltration anaesthesia with procaine for skin and fields of operation, and topical anaesthesia with dicaine 100mg for pelvic viscera. Endometriotic implants were cauterized with microwave and all cysts were punctured and enucleated. Salpingoplasty for hydrosalpinx, linear salpingostomy for tubal pregnancies and myomectomy can all be done successfully under microwave. Results: Patients were followed for 12￣68 months. Among 193 cases of endometriosis 89 with infertility, 54(61%) conceived after treatment. Among 101 cases with ovarian endometriomas, cysts disappeared in 79(78%),decreased in size in 19(19%) but no change in 3(3%) .Among 169 cases with pelvic pains, complete relief were achieved in 112(66%), partial relief in 45(27%), no change in 12(7%) after operations. All the patients with ovarian cysts, tubal pregnancies and subserous myomas of uterus were all successfully treated under laparoscopy. There were no complications. Conclusion: The advantages of laparoscopic operations under local anesthesia are obvious. Operative laparoscopy with microwave is efficient in cutting,coagulating and hemostasis. No smoke blur the vision.Trauma is superficial and pregnency rate following operation is high. The microwave generator is easier to operate and less expensive.