Diode Laser in Gynecologic Laparoscopic Surgery

Materials and methods
Beijing Union Medical College Hospital Obstetrics and Gynecology and Laser Center in September 2005 to March 2006, in a television under the application of semiconductor laser imaging and its accessories with the laparoscopic treatment of 36 patients with gynecological diseases.

1 General Information: Age 23 ~ 45 years old, are married. Of which 23 cases of infertility.

2 Anesthesia Methods: a comprehensive local anesthesia, or intravenous injection of
pethidine, phenergan, parallel with hydrochloric acid Dihydroetorphine 20μg sedation
analgesics. Skin incision under local anesthesia with procaine. Pelvic internal organs with
0.5% tetracaine 20 ml (100 mg) Penbu for topical anesthesia. Surgical area was added, and
1:16 10000 procaine adrenaline for infiltration anesthesia.

3 Surgical methods: conventional laparoscopic insertion through a special catheter
inserted to connect the flexible optical-fiber laser (diameter 600μm), this catheter in the
surgical laparoscopic. Continue to introduce optical fiber until the TV to see the exposed
fiber laparoscopic about 1 ~ 1.5 cm, activate the laser, you can use. Laser in continuous
mode, by the surgeon with the foot switch control. Such as organizations or separation of
adhesions vaporization, using contact-type, power 8 ~ 13 W; such as the burning endometriotic lesions or coagulation to stop bleeding, using quasi-contact, power 7 ~ 10
The use of quasi-contact optical fiber can be by adjusting the power, the role of distance
and time to control, so that for therapeutic purposes. The distance between the probe and
organizations in general for 2 ~ 4 mm, the role of time of 2 ~ 4 seconds. According to
different conditions for the second abdominal incision (diameter 0.5 ~ 1 cm), enter the
required surgical instruments.


(1)Ovarian chocolate cyst and other benign ovarian cystectomy: cyst puncture and
aspiration washed clean, with its laser-cut surface of the ovarian tissue, stripping out the
cyst, residual cyst wall and bleeding punishable by laser or electrocoagulation cautery,
incision without suture.
(2) Resection of ovarian cysts: cyst puncture and red smoke after the cyst pull to bring to
the middle of the laser to cut off the sections of ovarian ligament and ovarian mesentery
until the free ovary.
(3)Crown ovarian cystectomy: cyst surface with a laser into a line of vascular coagulation,
after carefully cut the line before the leaves broad ligament peritoneum, stripped most of
the cyst, cystic fluid extracted, reverse grip cyst, complete out..
(4) Endometriosis ablation lesions: Note anatomic site, quasi-contact laser burning of
ectopic lesions, so pale.
(5) Pelvic adhesions dissection: Exposure adhesion site, a certain tension, away from the
organ, laser contact adhesive tape, paragraph by paragraph cut, separate adhesion.
(6) Oviduct ostomy: In the tubal end of the enlarged area of stagnant water in order to
Laser "10"-shaped incision, release of liquid, and then a low-power laser cauterizing the
serosal surface umbrella side to make it contraction valgus, and bleeding.

(7)Subserosal myomectomy: paragraph by paragraph, along the fibroid at the base of
laser cut pulp muscle, clamping fibroids Niuchu, laser to stop bleeding wounds.
(8) Polycystic ovarian drilling technique: The laser irradiation optical fiber insertion hole of
ovarian follicles: Every hole diameter of 3 ~ 4 mm, the depth of 4 ~ 6 mm, number of
holes depending on size of the ovaries, after punching the release of follicular fluid, ovary,
compared with surgery before the relaxation narrowing.
(9) Conservative surgery of tubal pregnancy: the Department of membrane in the fallopian
tubes into the vasoconstrictor, mesangial longitudinal side with a laser-cut parts of tubal
pregnancy, clip out the pregnancy, and blood clots after washing the product of the
incision is not sutured. Surgical specimens removed from the abdominal incision, and sent
to pathology. All operations until the pelvic injection lactate Ringer's injection, and
metronidazole, gentamicin reserved. 4 hours ~ 2 days after discharge.
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