THE USE OF POTASSIUM-TITANYL-PHOSPHATE LASER FOR LAPAROSCOPIC REMOVAL OF OVARIAN ENDOMETRIOMA

From January 1989 through January 1990, 31 patients thought to have ovarian endometrioma at ultrasonography were treated by operative laparoscopy and potassium-titanyl-phosphate laser. The endometriomas ranged from 2 to 9.2 cm in diameter by preoperative transvaginal ultrasonography. The operative procedure used was a three-puncture technique with a 600-mu-m fiber attached to a potassium-titanyl-phosphate laser. The power setting was 10 W with a continuous pulse. In all cases endometriomas were opened, drained, and irrigated, and the potassium-titanyl-phosphate laser was used to vaporize or remove the entire cyst lining. The ovarian edges were inverted with the laser at the end of the procedure. With one exception, there was no recurrence of endometrioma at 1, 3, and 6 months after the procedure, on the basis of transvaginal ultrasonography or laparoscopy. In one case, 4 months after the initial laparoscopic procedure, exploratory laparotomy was performed for resection of a large, recurrent endometrioma. The use of the potassium-titanyl-phosphate laser allows the laparoscopic surgeon an aggressive approach to ovarian endometriomas that in the past necessitated exploratory laparotomy.