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This paper reports operative laparoscopy in 98 gynecologic patients with benign disease, comparing laser equipment (Nd:YAG, KTP/YAG, Ho:YAG) against electrocautery modalities and the harmonic scalpel across multiple procedures (e.g., ovarian cyst treatments, adhesion lysis/TUSL, and LAVH, which was performed for conditions including adenomyosis). In endometriosis with endometrioma, 69.2% reported >50% pain relief and 11.5% reported no menstrual pain after surgery, but recurrent endometrioma occurred in 42.3%; in endometriosis overall, pain relief rates were 71.4% (>50% relief) and 23.8% (no menstrual pain). The authors state complications during and after operation were minimal and found no difference between the laser group and other instrumentation in outcomes or complications. This paper is centrally about endometriosis — it reports laparoscopic laser surgery outcomes for endometriosis and recurrence rates of endometrioma.
Abstract
Operative laparoscopy was performed on ninety-eight cases with gynecologic benign disease. Lasere equipments (Nd: YAG, KTP/YAG, Ho: YAG), electrocautery (monopolar, bipolar, Argon beam coagulator) and Harmonic scalpel were used. For the treatment of ovarian cyst, drainage, ethanol fixation, ablation of lining, stripping of lininig (intra orextracorporeal) and adnexectomy were performed on them. For adhesion, lysis, and/or TUSL (Transection of Utero Sacral Ligament) were carried out. For myoma, adenomyosis, carcinoma in situ of uterine cervix and descensus uteri with adhesion, LAVH (Laparoscopically Assisted Vaginal Hysterectomy) were carried out.In the group of endometriosis with endometrioma, 69.2% (18 of 26) reported over 50% pain relief and 11.5% (3 of 26) reported no pain from menstrual pain after the surgery. Recurrent endometrioma was found in 42.3% (11 of 26). In the group of endometriosis, 71.4% (15 of 21) reported over 50% pain relief and 23.8% (5 of 21) reported no pain from menstrual pain. In the group of pelvic inflammatory disease and dysmenorrhea, 57.1% (4 of 7) reported over 50% pain relief and 28.6% (2 of 7) reported no pain from menstrual pain. In the group of ovarian cyst, recurrent cyst was found in 5.9% (1 of 17). All patients after the LAVH had no complaints.Their complications during and after the operation were minimal. There was no difference between the Laser group and the other group in the results and complications.
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腹腔鏡下レーザー手術
他の機器との比較検討
1995 年 16 巻 Supplement 号 p. 213-215
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Operative laparoscopy was performed on ninety-eight cases with gynecologic benign disease. Lasere equipments (Nd: YAG, KTP/YAG, Ho: YAG), electrocautery (monopolar, bipolar, Argon beam coagulator) and Harmonic scalpel were used. For the treatment of ovarian cyst, drainage, ethanol fixation, ablation of lining, stripping of lininig (intra orextracorporeal) and adnexectomy were performed on them. For adhesion, lysis, and/or TUSL (Transection of Utero Sacral Ligament) were carried out. For myoma, adenomyosis, carcinoma in situ of uterine cervix and descensus uteri with adhesion, LAVH (Laparoscopically Assisted Vaginal Hysterectomy) were carried out.
In the group of endometriosis with endometrioma, 69.2% (18 of 26) reported over 50% pain relief and 11.5% (3 of 26) reported no pain from menstrual pain after the surgery. Recurrent endometrioma was found in 42.3% (11 of 26). In the group of endometriosis, 71.4% (15 of 21) reported over 50% pain relief and 23.8% (5 of 21) reported no pain from menstrual pain. In the group of pelvic inflammatory disease and dysmenorrhea, 57.1% (4 of 7) reported over 50% pain relief and 28.6% (2 of 7) reported no pain from menstrual pain. In the group of ovarian cyst, recurrent cyst was found in 5.9% (1 of 17). All patients after the LAVH had no complaints.
Their complications during and after the operation were minimal. There was no difference between the Laser group and the other group in the results and complications.
In the group of endometriosis with endometrioma, 69.2% (18 of 26) reported over 50% pain relief and 11.5% (3 of 26) reported no pain from menstrual pain after the surgery. Recurrent endometrioma was found in 42.3% (11 of 26). In the group of endometriosis, 71.4% (15 of 21) reported over 50% pain relief and 23.8% (5 of 21) reported no pain from menstrual pain. In the group of pelvic inflammatory disease and dysmenorrhea, 57.1% (4 of 7) reported over 50% pain relief and 28.6% (2 of 7) reported no pain from menstrual pain. In the group of ovarian cyst, recurrent cyst was found in 5.9% (1 of 17). All patients after the LAVH had no complaints.
Their complications during and after the operation were minimal. There was no difference between the Laser group and the other group in the results and complications.
© 特定非営利活動法人 日本レーザー医学会
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