Abstract
Laparoscopic uterosacral nerve ablation (LUNA) has been clinically performed on 9 cases of functional dysmenorrhea, which is defined as the severe dysmennorrhea showing minimum signs of endometriosis by laparoscopic examination except for the thickened and/or callous uterosacral ligaments. The potassium-titanyl-phosphate (KTP 532) laser has been applied to the laparoscopic surgery via thin flexible optic glass fiber of 600 micron in diameter, characterized by the visible green light of 532nm, showing minimum attenuation in transparent fluids of ascites or saline solution without any necessity of aim beam. KTP 532 is radiated as the doubled frequency or second harmonics of conventional Nd: YAG laser of 1064nm by adding some components of non-linear Q-switch. The ablation of uterosacral ligament has been performed as the vaporization of the posterior portion of ligament closely adjacent to uterine cervix with 1-2cm in length and about 1cm in depth.
Clinical evaluation has resulted in the 4 cases of complete remission and 3 cases of significant relief, with 2 cases of ineffective outcome, both of which has been documented as a superficial or insufficient ablation performed as the initial two cases, definitely suggesting the effective alternative treatment for this difficult and ineffective disorders by the conventional remedies.
