Surgical Treatment of Endometriosis via Laser Laparoscopy and Videolaseroscopy

The CO2 laser has been used laparoscopically for the removal of endometriotic implants, drainage of endometriomas, and lysis of adnexal adhesions in 102 patients. These patients were followed for a period ranging from 12 to 18 months, during which there were 62 pregnancies including 9 spontaneous abortions and 1 elective termination of a pregnancy. The rates of conception after surgery were as follows: 75% for patients with mild endometriosis (stage I/American Fertility Society), 62% for patients with moderate endometriosis (stage II/AFS), 42.1% for patients with severe endometriosis (stage III/ASF) and 50% for patients with extensive endometriosis (stage IV/AFS). Standard treatment of infertility associated with endometriosis includes both medical (danazol, oral contraceptives, progestins) and surgical (laparotomy, laparoscopy), or combined approaches. This study reports on the CO2 laser used laparoscopically in the treatment of endometriosis associated with infertility. Of 102 patients presenting with infertility attributed to endometriosis, 60.7% conceived within 24 months following laser laparoscopy. In this patient group, no immediate or subsequent laparotomy was required prior to achieving conception, nor was hormonal therapy enacted during the postsurgical study period.