|
ENDOMETRIOSIS
MAY BE TREATED WITH LASER SURGERY
It was not too many
years ago that if a woman received a diagnosis of
endometriosis when she was past her childbearing
years, her only alternative to putting up with the
routine pain and discomfort was major surgery. Today,
endometriosis is just one of the many gynecologic
problems that can be effectively and safely treated
with the relatively new laparascopic laser techniques.
Laparoscopy involves
the insertion of a slender light-containing
“telescope” into the abdomen. It can be angled in
every direction so that the surgeon - looking through
the laparoscope- can actually see most of the organs
and structures inside the abdominal and pelvic
cavities.
The first gynecologic
application of the carbon dioxide laser through the
laparoscope was done in 1979. Since then, improved
instrumentation and the introduction of video support
has enabled surgeons to perform increasingly more
complex procedures to treat a variety of benign pelvic
diseases. Videolaseroscopy - as the technique is
called when it incorporates the use of a video
camera-offers a simple and inexpensive alternative to
more invasive surgical techniques, especially when it
is done in concert with the diagnostic laparoscopy.
Gynecologic surgeons experienced in videolaseroscopy
are successfully using the procedure to treat
endometriosis, endometriomas, adhesions and
hydrosalpinges, as well as ruptured and unruptured
ectopic pregnancies, dermoid cysts and ovarian
abscesses.
Thanks to the
development of fiber optics and sophisticated video
technology, the surgeon - as well as the entire
surgical team - sees a panoramic and magnified view of
the pelvic area on a TV monitor. This makes it
possible to reach a conclusive diagnosis and often to
initiate the appropriate treatment at once, using a
laser beam through the laparoscope.
Laparoscopy, a brief
and relatively uncomplicated procedure that causes
minimal discomfort, is a valuable diagnostic tool
because it provides the physician with a direct view
of the abdominal organs. At the outpatient center, a
general anesthesia is administered to the patient.
After it has taken effect, a tiny incision is made in
the lower abdomen to introduce a special gas that will
inflate the abdomen and lift the abdominal wall away
from the internal organs.
Once the procedure is
complete, the gas is released through the incision,
the laparoscope is removed and the incision is closed
with sutures and covered with a band-aid. After
resting for few hours in the recovery area, patients
are allowed to have someone take them home.
Other than some minor
discomfort that can be relieved by using mild
analgesics, most patients find that they are
comfortable resuming normal activities within a few
days. There are usually no complications.
The benefits for the
patient as compared to invasive surgery are quite
compelling; it is accomplished in out patient surgery,
the recovery period is shorter, the patient can often
return to work or a normal lifestyle quicker, the
scars are smaller and more esthetically pleasing to
the patient, and the risks and complications of major
surgery are avoided.
The advantages of
videolaseroscopy will continue to increase with
technological improvements, and the procedure will
continue to make significant changes in the field of
reproductive surgery.
|
