[Thermal preparation techniques in gynecologic endoscopy--technical, experimental and clinical results (n=2000)]

A comparative study on thermal, mainly laser and high frequency electrosurgical techniques, was conducted. Indications, handling and morphometric results were correlated. Morphometrical findings suggest that minimal thermal tissue damage is associated by a decrease in the hemostatic effect. Additional bipolar coagulation is necessary when using the carbon dioxide laser or high frequency electrodes. As thermal tissue lesion is concerned, the two techniques differ only slightly, by fractions of millimeters. Concerning clinical handling and practicability at our department, as well as in the centers participating at the European Consensus Study on Lasers in Gynaecology, high frequency electrosurgery has proven the method of choice for endoscopic ablative procedures. The carbon dioxide laser (at laparoscopy) and the Nd:YAG contact laser (at hysteroscopy) are preferentially employed for reconstructive surgery (e.g. the carbon dioxide laser for treatment of distal tubal pathology or endometriosis, the Nd:YAG contact laser for hysteroscopic synechiolysis).