Improved
visualisation of endometriosis using a new spectral
analysis autoflourescence laparoscopy system: a pilot
study
First prize for technical achievement
was awarded to Dr Steven Palter at the 62nd annual meeting
of the ASRM for a new surgery technique that enables
surgeons to see tumours and other pathologies invisible
with previous methods.
Illumination of certain tissues with specific light
wavelengths results in autoflourescence of the tissue,
which can be seen using a combination of illumination
and observation filters. The spectral analysis laparoscopy
(SAL) system allows the visualisation of tiny amounts
of such autoflourescence.
Previously, the SAL system has been used for the detection
of lung and bladder carcinoma, where it increases the
sensitivity of visualisation. At the October ASRM meeting
Dr Palter presented the results of the first prospective
systematic evaluation of the ability of such a system
to identify peritoneal endometriosis in comparison with
white light laparoscopy.
Ten women with infertility or chronic pelvic pain underwent
standard white light laparoscopy for suspected endometriosis,
with documentation of all potential lesions followed
by visualisation with the two illumination and two observation
filters. All potential lesions were photodocumented
for each examination. All suspected lesions were excised
and examined histologically to confirm the presence
of endometriosis.
More than 70% of the women who had white light documented
endometriosis had additional lesions visualised using
the SAL system, and more than 70% of the lesions identified
using this system were histologically documented to
have endometriosis or endosalpingiosis.
The team also observed a novel type of small vesicular
implants with intense yellow-green autoflourescence.
There were also histologically confirmed to be endometriosis
or endosalpingiosis.
Whereas the use of the autoflourescent SAL laparoscopy
system allowed the identification of subtle lesions
of early stage endometriosis that would otherwise have
been missed by traditional white light laparoscopy,
further studies are indicated to assess if the use of
this system is related to improved clinical outcomes.
|
