Excision of Endometriosis Superficial Bowel Serosa

Patrick P. Yeung, Jr., MD, FACOG

The UltraPulse laser is singular in its ability to excise tissue exactly as intended and with a controllable depth of penetration, and should be regarded as the cutting tool of choice of delicate vital structures. Complete disease removal, even over areas such as the large and small bowel can be achieved. Results of complete excision by expert surgeons give excellent clinical outcomes for both pain and fertility.

The UltraPulse produces a particular confined area of thermal injury. This is advantageous to avoid tissue distortion, preserve organ functionality, and to minimize adhesion formation.

Laser treatment speed can be changed easily by adjusting laser power. Thermal impact can be tuned by adjusting the pulse energy level in UltraPulse mode. Starting at 125 mJ:

1. Higher pulse energy generates less thermal injury
2. Lower pulse energy generates somewhat higher thermal injury and aids hemostasis

Some of the CO₂ insufflation gas is continuously entering the laser laparoscopy and streaming down the operative channel to avoid thermal blooming and keeping it clear from smoke which can impede the laser beam.

The safe use of the UltraPulse carbon dioxide (CO₂) free-beam laser requires proper use and maintenance of the equipment, proper hands-on training, and adequate first-hand experience through a learning curve."