[Distal tubal microsurgery using the CO2 laser. Experimental study and analysis of a series of 95 cases]

After having used the CO2 laser in gynaecological surgery for 5 years, can we already work out a balance of the effects of laser in this field and especially in tubal microsurgery? An experimental study was carried out on 2 groups of rabbits, the first group being one where artificially created adhesions were freed without any residue thanks to the CO2 laser, and a second group where the uterine cornua could be sutured using pulses of laser and no sutures. 95 microsurgical tubal operations were carried out using the CO2 laser between 1979 and 1983. Adhesiolysis was carried out in 39 patients with 25 intra-uterine and one extra-uterine pregnancies resulting. Fimbrioplasty was carried out in 41 patients with 24 intra-uterine and 2 extra-uterine pregnancies. Salpingostomy was carried out in 15 patients with 5 intra-uterine pregnancies and one extra-uterine pregnancy. A second surgical procedure was carried out in 20 patients with 7 intra-uterine pregnancies and one extra-uterine pregnancy. The CO2 laser makes microsurgical techniques easier and avoids recurrent adhesions, giving rise to a level of pregnancies in the region of 60% after adhesiolysis and fimbrioplasty. This latter term was used for the reconstruction of the ampulla, which had only partially been blocked. On the other hand, when there is a hydrosalpinx with total loss of patency, the laser is no more successful than classical microsurgical techniques.