Chirurgia endoscopica : il laser CO2
What are the advantage of CO2 lasersurgery
surgery is better because of precision and the haemostatic capacities and the minimal tissue damage
This results in a precise surgery with probably less adhaesieons
This is very important for superficial endometriosis and for deep endometriosis because of fast vaporisation and fast excision.
Maar is niet geschikt voor dissectie chirurgie
Bikini -incisions
Set-up zoals gebruikt sinds 1990
Set-up : 2 secondaire trocars
The fist trocar is put in the umbilicus except when severe adhesions are expected. vergroeiingen)
The secondary trocars : only with CO2 laser surgery 2 additional trocars are sufficient for interventions as superficial endometriosis and fertility surgery. These in addition can be placed very low. For electrosurgery we always need 3 trocars gebruikt te worden placed slightly higher.
Laserchirurgie
Electochirurgie
Are there disadvantages ?
Only the cost of the laser and the necessary other devices such as a high flow insufflator (only the Thermoflator is suited for this.
The major problem is that the surgeon needs additional training first in open surgery, then in laparoscopic surgery and then in laser surgery.
asersurgery and Electro surgery are complementary/h4>
Laser is better for superficial and deep endometriosis
Electo surgery is better for dissection ie lymfadenectomy, pelvic floor or ureter and bowel surgery.
Fotr deep endometriosis we thus need both since the Co2 laser will shorten surgery by 1 to 2 hours .
If laser surgery is better for endometriosis, why is it not used systematically ?
1. Few gynaecologist have the training for both electrosurgery and laser surgery.
2. The necessary equipment is not always available . This is not surprising when few surgeons can use it
