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. 2021 Nov;304(5):1221-1231.
doi: 10.1007/s00404-021-06154-z. Epub 2021 Aug 26.

Laparoscopic treatment of deep endometriosis with a diode laser: our experience

Stefano Angioni  1 , Luigi Nappi  2 , Felice Sorrentino  2 , Michele Peiretti  3 , Angelos Daniilidis  4 , Alessandro Pontis  5 , Raffaele Tinelli  6 , Maurizio Nicola D'Alterio  3
Affiliations

Laparoscopic treatment of deep endometriosis with a diode laser: our experience

Stefano Angioni et al. Arch Gynecol Obstet. 2021 Nov.

Abstract

Purpose: To evaluate whether laparoscopic treatment with a diode laser is feasible, safe, and effective in symptomatic patients affected by deep endometriosis (DE).

Methods: This retrospective study was performed using medical record data. The surgical reports, chronic pain scores, and quality of life (QoL) data were evaluated for 50 patients who had undergone laparoscopic surgery between November 2017 and March 2019 at two university hospitals (Monserrato (CA) and Foggia, Italy). Indications for surgery were chronic pelvic pain and/or infertility in patients who wished to conceive spontaneously. Endometriosis lesions/nodules were excised using a diode laser (Leonardo®, Biolitec® DUAL 45) that can combine 980 and 1470 nm wavelengths transmitted through a 1000 µm conical optical fibre.

Results: The median patient age was 32 years (range 21-44), with a body mass index (BMI) mean of 21.7 ± 2.9 kg/m2. The mean operation time was 147 min (range 106-190). No intraoperative or early complications (< 30 days) were reported. All patients left the hospital, on average, within 3 days (range 2-9 days) after surgery. A significant improvement in pain was observed at the 3-, 6-, and 12-month follow-up (p < 0.01) in all patients. Moreover, patients reported a significant QoL improvement at the 12-month follow-up.

Conclusion: The diode laser confirmed its feasibility and safety for treating endometriosis. During the shaving surgical procedure, the diode laser system ensures a safe and effective laparoscopic dissection of deep endometriotic lesions. Further comprehensive randomized trials are necessary to confirm these preliminary data in terms of efficacy, recurrence rates, and pregnancy outcomes.

Keywords: Deep endometriosis; Diode laser; Endometriosis; Pelvic pain; Quality of life; Surgical treatment.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Leonardo DUAL 45 laser device
Fig. 2
Fig. 2
Diode laser ureterolysis
Fig. 3
Fig. 3
Vaginal nodule delimitation with the diode laser by vaginal route
Fig. 4
Fig. 4
Laparoscopic excision of deep endometriosis infiltrating uterosacral ligaments
Fig. 5
Fig. 5
Cumulative pain scores at 0, 3, 6, and 12 months (*p < 0.01 vs. baseline)
Fig. 6
Fig. 6
Differences in the patients’ quality of life, as assessed by SF36, before surgery and at 12 months follow-up (*p < 0.01 vs. baseline)
See this image and copyright information in PMC

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