Ex vivo myolysis with dual wavelengths diode laser system: Macroscopic andhistopathological examination

Uterine fibroids are the most common benign gynaecological tumours in women. Whensymptomatic, heavy menstrual bleeding is the principal manifestation of uterinefibroids. Nowadays, several conservative procedures have been utilized to discouragehysterectomy or myomectomy and great interest has been focused on laser energytechnology associated with mini-invasive approaches. Diode lasers demonstratedmany advantages in laparoscopic and hysteroscopic surgery. To evaluate the DualWavelength Diode Laser System (DWLS) ablation techniques for treating fibroids, wedevised an experimental system for characterizing the myolysis fibre ablationperformance with a particular fibre designed to create a thermal ablation in the centreof the myoma. All the myomas were used for the experiment after a total hysterectomyand their excision from the fresh uteri. The experiment setup was composed of twobeaker containers filled with isotonic saline water, temperature monitoring myomasurface and water bath, a diode laser fibre and a diode laser energy deposition system.Good macroscopic results have been found for fibroids of about 60 cm3 ablated with asetting of 10 W of 980 nm + 10 W of 1470 nm and for samples of about 15 cm3 ablated with a setting of 5 W of 980 nm + 5 W of 1470 nm, where the volume of the ablatedfibroids were 46.6% and 41.6%, respectively. This is the first ex vivo study with a newDWLS, which made it possible to understand which one of its settings could berecommended for the safest and best macroscopic results in myolysis.