INTERSTITIAL LASER TREATMENT OF THE OVARY - AN EXPERIMENTAL-STUDY IN GOATS

Background and Objective: Interstitial laser treatment (ILT) of the ov ary might be a new surgical approach to restore ovulation with a minim al risk of adhesion formation in patients with chronic hyperandrogenic anovulation who are unresponsive to hormone therapy. The objective wa s to investigate the feasibility of inducing a lesion limited to the c enter of the ovary in an animal model. Study Design/Materials and Meth ods: ILT was performed in seven goats using Nd:YAC; laser in combinati on with ultrasound monitoring. The extent of direct thermal damage was investigated in two goats, treating both ovaries during a laparotomy at 2, 4, 6, and 8 W, respectively, for 5 min. Adhesion formation was e valuated in five goats 81 days after an unilateral laparoscopic ILT at 1, 2, 4, 6, or 8 W for 5 min. During treatment temperatures on the su rface of the ovary were measured. Results: Histology after 1 day showe d sharply demarcated necrotic lesions located centrally or subcapsular ly at low powers, whereas at higher powers the lesions extended to the surface of the ovary. At low powers no adhesions were observed, where as higher powers resulted in periovarian adhesions. Temperatures measu red on the ovarian surface during treatment ranged between 38 degrees C and 90 degrees C. Ultrasound monitoring of the extent of thermal dam age failed due to poor positioning. Conclusion: Although this pilot st udy does not warrent firm conclusions, the results indicate that ILT o f the ovary is feasible and that lesions without adhesions can be prod uced at low powers. The use of ultrasound to monitor the extent of the rmal damage in the ovary should be a subject of further evaluation. (C ) 1996 Wiley-Liss, Inc.