Excision of pelvic endometriosis with the carbon dioxide laser laparoscope

Laparoscopic vaporization of peritoneal endometriosis has been reported to relieve pain and enhance fertility. However, vaporization of endometriosis, particularly large plaques and hemorrhagic areas, is associated with significant amounts of carbon deposition in the desicated tissues. Further, it is difficult to ascertain complete removal of disease in some areas. In this study, 66 patients were treated by excision of peritoneal and/or ovarian endometriosis with the carbon dioxide laser via laparoscopy. Using excisional techniques, we were able to visualize the extent of peritoneal penetration and subperitoneal spread of endometriotic nodules. Further, we obtained histologic confirmation of the disease process in all patients. No patient received postoperative hormonal therapy during follow-up. Follow-up evaluation of these patients revealed relief of the painful symptoms of endometriosis. No long-term complications were encountered.