Laparoscopic use of the argon laser in nonendometriotic reproductive pelvic surgery.

The major advantage of the argon laser in laparoscopic reproductive pelvic surgery is the ability to transmit the laser beam along a flexible fiber that can easily be directed at a lesion. Its use has been specifically described for the treatment of endometriosis because the absorption of the argon laser beam (488 + 514 nm) coincides with the pigmented endometriotic implants. It has been suggested that the argon laser would not be as useful in other infertility procedures because the lack of such pigmentation would reduce the lesion's absorption of the laser beam and therefore decrease the laser's efficacy of destruction. The argon laser was used in other kinds of reproductive pelvic surgery in 15 patients over seven months. Procedures performed laparoscopically with the laser were neosalpingostomy, fimbrioplasty, salpingo-oophorolysis, adhesiolysis and ablation of the uterosacral ligaments. Of six patients undergoing laparoscopic surgery with a preoperative diagnosis of pelvic pain, five reported complete resolution of the pain following therapy. There were no intraoperative or postoperative complications. In the short follow-up period, none of the patients conceived. In addition to its use in the treatment of endometriosis, the argon laser, transmitted laparoscopically via a fiber, can be safely used to perform a wide variety of other reproductive pelvic surgical procedures. Its relative efficiency with regard to these procedures, the subsequent pregnancy rates and the laser's ability to ameliorate pelvic pain remain to be established.