The contact Nd:YAG laser: a new technique for conservation of the fallopian tube in unruptured ectopic pregnancy

Abstract

Between August 1986 and April 1988,22 women with unruptured tubal pregnancy were treated by laparoscopy in the Department of Gynaecology and Obstetrics at the University of Ulm. Linear salpingotomy was performed using the contact Nd:YAG laser technique. The laser beam was delivered by special sapphire probes attached to a standard optical fibre for incision and coagulation. Two different shapes of sapphire probes were used. The specific laser properties and the application of vasopressin enabled treatment without any other incision instruments or coagulation agents. In one patient subsequent laparoscopy became necessary due to persisting trophoblastic tissue. Sixteen women were assessed subsequently by second-look laparoscopy or hysterosalpingography for tubal patency and possible formation of adhesions. In 14 (88%) women the tubes were patent, and in two women adhesions were seen.Advances in diagnosis, such as vaginal ultrasound and more sensitive tests for beta human chorionic gonadotrophin (P-hCG) over the past decade have Icd to an increased proportion of tubal pregnancies being diagnosed before rupture. Conservation of the fallopian tube and thus

Evaluation of the success rate of medical management of ectopic pregnancy in a tertiary level teaching hospital in Kerala" during a three year period from October 2003 and September 2006

“…Thepregnancy rates and tubal patency post MTX treatment have been exclusively studied. Post treatment hysterosalpingogram have demonstrated ipsilateral tubal patency in 77.8% cases treated with single dose methotrexate 20,21 . These figures are comparable to tubal patency rates after linear salpingostomy 22 .…”

Is Removal of the Tube Mandatory after Coagulation in Ectopic Pregnancies

“…Others [16][17][18] reported methotrexate injection under laparoscopic control. Laser linear salpingostomy by lap aroscopy has recently been described [19],…”

Modern Lines of Management of Ectopic Pregnancy

“…Haemostasis is achieved with the endocoagulator, laser or vasoconstricting agents. Contact Nd: YAG 72 , CO 2 73 or Argon‐laser 74 may also be used with endoscopic surgery for opening the tube. Postoperatively, patients who had conservative surgery should be observed with weekly assessment of hCG titres to ensure complete resorption.…”