Laser Ablation in Gynecology
ablation is type of endometrial ablation (sometimes misspelled
as "oblation" or "ablasion",
also called uterine ablation and uterus
ablation), which is a surgical technique to stop heavy bleeding
during the period.
loss of blood during the period is around 25 ml, and anything
above 80 ml is too large. Besides anemia and the problems it
can bring you, losing so much blood may make your life unbearable.
Many women describe this not as having a period but as downright hemorrhaging.
It is difficult to live when you cannot sleep, cannot move because
of blood, cannot go to work for several days or even for a whole
week. It is exactly in this situation when you say "I can't
live like this anymore, doctor, do anything, just save me now!" Next
thing you know, you're discussing all kinds of surgery, all up
to hysterectomy. If you're lucky, and fall into one of the groups
of patients described below, you can settle for "smaller" surgery
such as endometrial ablation.
Laser ablation is a good alternative
to other types of ablation of the uterus. Laser stands short for
Light Amplification by Stimulated Emission of Radiation. It has been
discovered in the middle of the twentieth century and has quickly
found its way to the various fields of medicine.
Lasers produce a hot, precisely focused beam of light, which can remove
or vaporize tissue and control bleeding. They are so focused that
are somethimes called the "scalpels of light". They can cut and destroy
tissues, shrink tumours or lesions, and seal (cauterize) blood vessels
to prevent excessive bleeding.
Applications of Lasers In Medicine
of the first applications of lasers in medicine was in
ophthalmology (treating eye problems),
followed by many uses in
dermatology (skin problems, esthetic
surgery). Lasers are also used in
gastroenterology (disorders of the stomach
gynecology , since 1989,
oncology (cancer treatment),
orthopedics (disorders of bones, joints,
muscles, ligaments, and tendons),
otolaryngology (ears, nose, and throat;
pulmonary care (for the respiratory system),
urology (the urinary tract and of the
male reproductive system),
Types of Lasers
There are three types of lasers used today in gynecology:
Carbon dioxide (CO2) laser. It cuts or
vaporizes tissues while minimizing the bleeding. Used for
laser. Can penetrate the tissues more deeply than other
lasers, so blod clots quickly. The surgeon can see and work
with the parts of the body for which an open surgery would
be needed without the laser.
Argon laser. Used for eye surgery, for
treatments of superficial skin disorders, and for photodynamic
therapy (PDT) to shrink or dissolve tumors by means of light-sensitive
In gynecology, lasers are most frequently used for
Lasers in Gynecology
Regulation of heavy bleeding (click here for general introduction
or non-cancerous tumors that cannot be removed or destroyed
pregnancy (development of a fertilized egg outside the uterus)
One of the well-known methods for endometrial ablation now is laser
ablation. It was first performed by Dr. Goldrath in 1979 using a Nd:YAG
the patient will have both the myoma and heavy bleeding, and both
can be treated with this laser. The Nd:YAG laser will better serve
the surgeon for fibroids, however, it can be used for ablation as
well in spite of its small field of focus. It would take an hour
to ablate a small uterus with this type of laser, and can come very
expensive in hospital costs. The results of laser ablation are comparable
to those of other devices, say roller electrode.
through laser ablation or through roller-ball ablation, the 95%
of patients can control their bleeding and the uterine size is reduced
to 50%. The final effect, the state of amenorrhea, will depend both
on the technique used and on the size of uterus. 60% of women with
preoperative uterine cavity less than 7 cm and only 30% of women
with uterine cavity less than 10 to 15 cm reach the goal, i.e. enter
the state of amenorrhea.
in all, the Nd:YAG and bipolar needles for fibroids result in the
same-day surgery, avoidance of hysterectomy, and elimination of
as with any other surgical procedure, you should first ask why the
physician chose that method for you and what are his or hers experiences
with the procedure, the rate of failure or success etc. Be an informed
patient and stick to your views until the doctor wins you over.
The person guiding the laser must be thoroughly trained for the procedure.
Even if the procedure is done in the doctor's office, the precautions
taken must be the same as for an inpatient procedure. All the personnel
should be trained and all the necessary equipment should be near and
Problems with Laser Ablation
wrong move and the laser will cut anything it touches. In the first
years of using lasers in gynecology, there were two deaths from
gas embolism. Both occured when the laser was activated while in
contact with endometrial tissue. A gaseous embolism occured, and
in those two cases, that led to death through irreversible cardiac
arrest. Thefore, oxygen and other drugs must be at hand if the need
arises for cardiopulmonary resuscitation (CPR). An emergency
transportation to a hospital or a similar acute care unit must be
provided whenever laser surgery is performed in a non-hospital setting.
Laser or non-laser, the general rules still apply. You can leave the
hospital or office when your vital signs have stabilized. If you were
sedated, you should not leave until you know who you are and where
you are. You should leave home accompanied by a responsible adult;
it is best not to drive while going home.
What Can Happen After Laser Ablation
will be pain so you will probably get some analgesic drugs (pain
relievers). Other possible risks are:
wound becoming infected, and
-- a perforation of an organ or tissue.
other pre- and post-op procedures have a look at the general page
for endometrial ablation on this site.
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