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Open Access 01-12-2023 | Laparoscopy | Original Article

First experiences with a diode laser in major gynecological laparoscopic procedures show lack of benefit and impaired feasibility

Authors: Saskia Spaich, Sebastian Berlit, Laura Berger, Christel Weiss, Benjamin Tuschy, Marc Sütterlin, Stefan Stefanovic

Published in: Lasers in Medical Science | Issue 1/2023

Abstract

Purpose

The aim of this study is to evaluate feasibility and potential benefit of a diode laser in major laparoscopic procedures in gynecology.

Methods

Between 2018 and 2020, a total of 42 cases were enrolled in this study comparing standard electrosurgery with diode laser-supported therapy in laparoscopic supracervical hysterectomy (LASH), total laparoscopic hysterectomy (TLH), or laparoscopic myoma enucleation (LME). Dual wavelength 45 W diode laser light was used to cut and coagulate during laparoscopy in the prospective interventional arm consisting of 11 cases, while 31 matching patients who received conventional treatment with monopolar/bipolar current for the same interventions were retrospectively identified in our laparoscopy database. Recruitment in the prospective interventional laser diode arm was terminated after only 11 patients (instead of planned 50) due to intense hemorrhage and massive smoke development.

Results

A total of 42 cases were analyzed (11 LME, 19 LASH, and 12 TLH). Strong smoke development was evident in all 11 cases in the diode laser arm. It was necessary to convert to bipolar or monopolar current in all hysterectomies (n = 9) with initial diode laser implementation due to increased bleeding and smoke development. Conventional current sources had to be used in LMEs (n = 2) due to excessive bleeding and poor visibility during enucleation of the fibroid. A significant difference (p < 0.0001) was observed regarding smoke development when comparing the laser arm with the control arm.

Conclusion

We found a 45-W diode laser to be inferior to electrosurgical techniques for major laparoscopic gynecologic surgeries regarding bleeding control and smoke development.

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Title: First experiences with a diode laser in major gynecological laparoscopic procedures show lack of benefit and impaired feasibility
Authors: Saskia Spaich
Sebastian Berlit
Laura Berger
Christel Weiss
Benjamin Tuschy
Marc Sütterlin
Stefan Stefanovic
Publication date: 01-12-2023
Publisher: Springer London
Keywords: Laparoscopy
Smoking and Nicotine Detoxification
Diode Laser
Supracervical Hysterectomy
Hysterectomy
Laser
Published in: Lasers in Medical Science / Issue 1/2023
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-022-03696-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

First experiences with a diode laser in major gynecological laparoscopic procedures show lack of benefit and impaired feasibility

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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