Low power interstitial photocoagulation of uterine leiomyomas by KTP/YAG laser

Abstract

Interstitial laser photocoagulation (ILP), which is a new method of low power thermal destruction of tumours by laser, was employed to treat laparoscopically 16 patients with symptomatic uterine leiomyomas who had declined laparotomy. The KTP/YAG laser, with wavelengths of 532 and 1064 nm, respectively, was employed. Holes were drilled in the myomas with a 600 μm quartz laser fibre employing the KTP component at 8 W and subsequent coagulation of the surrounding myoma tissue was accomplished during the withdrawal of the fibre over the course of 10–30 s but using the YAG component at 8 W. Further holes were bored 2 cm from the original one and the process repeated until the whole myoma had been treated. All but one patient became symptom-free and have remained so. Eleven were cured with or without residual scarring, one became pregnant before the myoma had completely disappeared, three were lost to follow-up and in one the treatment largely failed. The results are extremely promising and warrant further research.