[Preclinical study of endoscopic laser coagulation of human ovaries]

The hemostatic potential of YAG laser irradiation was investigated in 21 hysterectomy and adnexectomy patients of childbearing age. Endoscopic forceps were used to induce hemorrhaging in the ovarian capsule. The hemorrhage was then irradiated from a distance of 2cm using a series of 1-sec. irradiations at either 30W or 50W until complete hemostasis occurred. In the 30W group, hemostasis was achieved after a total irradiation of 4.1 +/- 1.6 sec. while a significantly shorter time of 2.5 +/- 0.8 sec. was required in the 50W group (p less than 0.01). The irradiation energy in the 30W and 50W groups was 107 +/- 45 J and 109 +/- 35 J, respectively. Tissue temperature was measured during laser irradiation at 5mm and 10mm from the center of irradiation at a tissue depth of 5mm. In the 30W group, the tissue temperature at the 5mm and 10mm points increased 6.6 +/- 2.0 and 2.5 +/- 1.1 degrees C, respectively, while the temperature in the 50W group increased 8.5 +/- 3.5 and 3.1 +/- 0.9 degrees C respectively. No remarkable histological changes were noted in either group following irradiation. YAG laser irradiation during endoscopy is therefore considered to be a highly effective hemostasis for minor hemorrhages caused by instrument manipulation during endoscopic surgery.