A Modified Technique of Laparoscopic Ovarian Drilling for Polycystic Ovary Syndrome Using Harmonic Scalpel
- *Corresponding Author:
- Ahmed AM Nasr
Obstetrics and Gynecology Department, Faculty of Medicine
Al-Azhar University, Egypt
E-mail: [email protected]
Received date: November 02, 2011; Accepted date: October 26, 2012; Published date: October 30, 2012
Citation: Nasr AA, El-Naser A, El-Gaber Ali A, El-Sattar MA, Mgeed AAE, et al. (2012) A Modified Technique of Laparoscopic Ovarian Drilling for Polycystic Ovary Syndrome Using Harmonic Scalpel. J Diabetes Metab S6:008. doi: 10.4172/2155-6156.S6-008
Copyright: © 2012 Nasr AA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To review our experience with a modified technique of laparoscopic ovarian drilling (LOD) using harmonic scalpel as a new energy modality and to compare its effect with electrocautery in managing Clomiphene resistant polycystic ovary syndrome as regard to ovulation rate, pregnancy rate, hormonal profile and ultrasonographic changes that reflect ovarian reserve and reproductive outcome.
Patients and methods: Sixty patients presented by infertility due to PCOS were randomly allocated into two equal groups. Group I was subjected to laparoscopic ovarian drilling using electrocautery and Group II were subjected to laparoscopic ovarian drilling using harmonic scalpel. All patients were assessed twice (before the induction procedure and three months later, if pregnancy did not occur). Patients were assessed clinically (to determine menstrual regularity and body mass index), sonographically (to measure ovarian volume and antral follicle count at time of ovarian quiescence) and laboratory (to measure basal serum LH, FSH, LH/FSH ratio, total testosterone and estradiol). Also a 2nd look laparoscopy was performed in those patients who failed to conceive within six months of the initial laparoscopic procedure to assess the presence of adhesion and its type.
Results: Laparoscopic ovarian drilling using harmonic scalpel improved menstrual pattern, ovulation rate, pregnancy rate, hormonal profile similar to electrocautery without a significant difference. However it was associated significantly with a minimal effect on ovarian volume, antral follicle count and post operative adhesion.
Conclusions: We consider our LOD technique using harmonic scalpel as a new energy modality in managing Clomiphene resistant polycystic ovary syndrome practicable with less extensive destruction of the ovarian capsule and thereby of the ovarian reserve and with minimal incidence of post operative adhesion.