Abstract
Laser have been applied to laparoscopic surgery in our institute since 1990. The methods for treating ovarian cysts are shown in this paper. Benign ovarian cysts diagnosed by careful preoperative examination including CT, ultrasound and tumor marker evaluation should be indications for laparoscopic surgery. Practically, 3-4 punctures are placed on the abdominal wall. Two basic methods, cystectomy and adnexectomy, are applied for ovarian cysts. For cystectomy, the capsule of the cyst is incised using laser after aspiration of the content, followed by separation of the cyst from the capsule with forceps. Laser coagulation is effectively used to stop minimal bleeding from the internal surface of the capsule after the separation procedure. The emptied capsule can be reformed to almost normal shape of ovary using fibrin glue. For adnexectomy, several methods have been introduced and used. The pedicle of the cyst can be severed to remove the adnex either by laser after ligation with loop sutures or by using Endo GIA. The other method is the coagulation of the mesoovarium and ovarianband followed by cutting with laser to remove the ovary.
Currently we use KTP/YAG laser which can generate two different kind of laser beams suitable for cutting and coagulation, making the operation procedure easy, safe and sure. Application of laser for laparoscopic surgery may be extended in future.
