Safety of the Helica Thermal Coagulator in treatment of early stage endometriosis

Abstract

The objective of this prospective study was to assess the safety and short-term outcome of the Helica Thermal Coagulator in the laparoscopic treatment of early stage endometriosis. Two hundred and fifty consecutive women with chronic pelvic pain and stage I and II endometriosis (r-AFS classification) were treated laparoscopically with the Helica Thermal Coagulator. No bladder, ureteric or bowel injuries occurred. None of the procedures was converted to laparotomy and there were no major peri-operative complications. The only complication was a vaginal perforation during dissection of the cul-de-sac in a patient with a vaginal vault endometriotic nodule. We conclude that the Helica Thermal Coagulator is a safe alternative for the treatment of mild to moderate endometriosis. Long-term efficacy studies are required to better assess the role of the device in laparoscopic management of endometriosis.

Laparoscopic Helica Thermal Coagulation for the Treatment of Early Endometriosis

“…Hill et al reported that the Helica TC represented an alternative treatment modality in the laparoscopic management of early-stage endometriosis, as it is a safe, inexpensive procedure. 16 Even at a very low distance from the treated tissue, the depth of tissue penetration has been reported to be less than 1.5 mm, which makes the instrument suitable for use around vulnerable structures. 12 Adding to its safety, the low levels of power used for the procedure lessens the risk of arcing to the surrounding tissue, rendering the technique intrinsically safer than other fulguration methods.…”

“…17 Tissue coagulation in a helium environment helps the operating surgeon to maintain a clear view of the destruction process, as no carbonization or smoke is generated during the activation of the device. 16 The cost of the Helica TC is less than that for conventional fulguration devices (i.e., laser, electrosurgery, or the Argon Beam Coagulator), and the instrument is easy to maintain. 16,17 No complications were recorded in our series, and all patients in this study were treated on a day-case basis.…”

“…16 The cost of the Helica TC is less than that for conventional fulguration devices (i.e., laser, electrosurgery, or the Argon Beam Coagulator), and the instrument is easy to maintain. 16,17 No complications were recorded in our series, and all patients in this study were treated on a day-case basis. Pelvic pain in endometriosis is very difficult to eradicate.…”

An Interview with Stefanos Chandakas, M.D., M.B.A., Ph.D.

“…9 The advantage of this energy is that it causes only 1-1.5-mm deep destruction of the tissue. This means that an average gynecologic surgeon can use it to treat areas of endometriosis that were traditionally not approached because of the high risk of injury.…”

“…Numerous published papers have shown that, for endometriosis up to stage II, this is an amazing way to treat women and achieve a nearly 100% cure rate. 9 These examples suggest that the MIS techniques being applied for gynecologic surgery could have broader applications in a variety of surgical areas. Has the field of gynecology pioneered these techniques?…”