First experiences with a diode laser in major gynecological laparoscopic procedures show lack of benefit and impaired feasibility.
Bipolar
Diode laser
Hysterectomy
Laparoscopy
Monopolar
Myoma
Journal
Lasers in medical science
ISSN: 1435-604X
Titre abrégé: Lasers Med Sci
Pays: England
ID NLM: 8611515
Informations de publication
Date de publication:
05 Jan 2023
05 Jan 2023
Historique:
received:
11
09
2022
accepted:
16
12
2022
entrez:
4
1
2023
pubmed:
5
1
2023
medline:
7
1
2023
Statut:
epublish
Résumé
The aim of this study is to evaluate feasibility and potential benefit of a diode laser in major laparoscopic procedures in gynecology. Between 2018 and 2020, a total of 42 cases were enrolled in this study comparing standard electrosurgery with diode laser-supported therapy in laparoscopic supracervical hysterectomy (LASH), total laparoscopic hysterectomy (TLH), or laparoscopic myoma enucleation (LME). Dual wavelength 45 W diode laser light was used to cut and coagulate during laparoscopy in the prospective interventional arm consisting of 11 cases, while 31 matching patients who received conventional treatment with monopolar/bipolar current for the same interventions were retrospectively identified in our laparoscopy database. Recruitment in the prospective interventional laser diode arm was terminated after only 11 patients (instead of planned 50) due to intense hemorrhage and massive smoke development. A total of 42 cases were analyzed (11 LME, 19 LASH, and 12 TLH). Strong smoke development was evident in all 11 cases in the diode laser arm. It was necessary to convert to bipolar or monopolar current in all hysterectomies (n = 9) with initial diode laser implementation due to increased bleeding and smoke development. Conventional current sources had to be used in LMEs (n = 2) due to excessive bleeding and poor visibility during enucleation of the fibroid. A significant difference (p < 0.0001) was observed regarding smoke development when comparing the laser arm with the control arm. We found a 45-W diode laser to be inferior to electrosurgical techniques for major laparoscopic gynecologic surgeries regarding bleeding control and smoke development.
Identifiants
pubmed: 36600026
doi: 10.1007/s10103-022-03696-9
pii: 10.1007/s10103-022-03696-9
doi:
Substances chimiques
Smoke
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
34Informations de copyright
© 2023. The Author(s).
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