Videolaseroscopy for the Treatment Endometriosis Associated with Infertility, Camran Nezhat, MD, Scott Crowgey, MD, Farr Nezhat, MD; Fertility and Sterility, 51:237, 1989

Recent advances in laparoscopic surgery have enabled the gynecologic surgeon to treat an increased number of diseases of the reproductive organs by using the laser through the laparoscope. This article reviews the results or 243 patients with infertility associated with endometriosis ranging in severity from mild to extensive who were treated by the same surgeon using CO2 laser laparoscopically with videocamera augmentation and control. Of the 243 infertility patients, 168 (69.1%) achieved pregnancy. The pregnancy rates were 71.8% in 39 patients with stage I disease, 69.8% in 86 patients with stage II disease, 67.2% of 67 patients with stage III disease, and 68.6% in 51 patients with stage IV disease. The life table and two-parameter exponential model were used to calculate monthly fecundity, "cure" and "probability of pregnancy" rates. The results indicate that videolaserscopic treatment of endometriosis associated with infertility, in surgically experienced hands, is at least as efficacious as other forms of therapy for mild and moderate cases of disease, but appears to be more successful than laparotomy for the more severe and extensive stages of disease.

Videolaseroscopy: A new Modality for the Treatment of Endometriosis and Other Diseases of Reproductive Organs, Camran Nezhat, MD; Colposcopy & Gynecologic Laser Surgery, Volume 2, Number 4, 1986

In the present study, a total of 311 patients underwent videolaseroscopy for a 12 month period. Of these, 257 patients had endometriosis (stage I to IV/AFS), and 54 patients had other pelvic pathology, such as adhesions or tubal disease. For the procedures discussed herein, the CO2 laser was used almost always through the operating channel of the laparoscope via an especially designed coupler by Cabot Medical (Nezhat coupler) or, occasionally, through a specially adapted second puncture trocar. A micromanipulator coupler was attached to the laparoscope or to the second puncture probe.

Surgery for Endometriosis, Camran Nezhat, MD, Sheryl Silfen, MD, Farr Nezhat, MD, & Dan Martin, MD; Obstetrics & Gynecology, 1991, 3:385-393

Advanced operative laparoscopy in general, and videolaseroscopy using CO2 laser via operative channel of the laparoscope and video, specifically, has revolutionized the management of endometriosis. Adhesion formation is reduced and subsequent fertility rates exceed those obtained with laparotomy. The most complicated cases of endometriosis, including involvement of the rectovaginal septum, gastrointestine, and urinary tract, can now be treated endoscopically by an experienced operative laparoscopist.

A Fresh Look at Ovarian Endometriomas, Farr Nezhat, MD, Ceana Nezhat, MD, Camran Nezhat, MD, & Dahlia Admon, MD; Contemporary Ob/Gyn, Vol. 39, No. 11, 11/94

Endometriosis of the ovaries has unique manifestations. A new classification of endometriomas offers practical implications for diagnosis and treatment.

Is Endoscopic Treatment of Endometriosis and Endometrioma Associated With Better Results Than Laparotomy, Camran Nezhat, MD, Wendy K. Winer, RN, BSN, Farr Nezhat, MD; Am J Gynecologic Health Vol. II, No. 3

Endoscopic treatment of endometriosis and endometrioma employing two different techniques was achieved on 20 infertility patients using the laser laparoscope with video augmentation or videolaseroscopy. Results of each technique are discussed.

Endoscopic Infertility Surgery, Camran Nezhat, MD, Wendy K. Winer, RN, BSN, Jeffrey D. Cooper, MD, Farr Nezhat, MD, Ceana Nezhat, MD; J Reproductive Medicine, 0024-7758/89/3402-127

Since the introduction of endoscopy by Jacobaeus in 1910, there has been a dramatic change in the pattern of and approach to the diagnosis and treatment of various diseases of the female reproductive organs. The advances in techniques of operative endoscopy, in high technology and in instrumentation (such as endoscopes, video cameras and videomonitors) have made it possible to perform laparoscopically many of the infertility-related procedures previously requiring laparotomy. The advantages of such surgery are the rapid recovery time, decreased time lost from work, smaller scars, reduced cost, avoidance of risks and complications of laparotomy, and perhaps, better results.

Adhesion Reformation After Reproductive Surgery by Videolaseroscopy, Camran Nezhat, MD, Farr R. Nezhat, MD, Deborah A. Metzger, PhD, MD, Anthony A. Luciano, MD; Fertil Steril 53:1008, 1990

After initial videolaseroscopy for the treatment of endometriosis-associated infertility, 157 patients underwent a second-look laparoscopy to evaluate and treat recurrence of disease and/or adhesions. The patients were divided into two groups. Group 1 consisted of 135 patients who underwent second-look laparoscopy for persistent infertility and/or recurrence of pain. Group 2 consisted of 22 patients who achieved a pregnancy after initial surgery and underwent second-look laparoscopy for evaluation of ectopic pregnancy or in association with uterine evacuation for first trimester spontaneous abortion. Both groups of patients demonstrated a significant reduction in adhesion scores involving the ovaries, tubes, posterior cul-de-sac, anterior cul-de-sac, and omentum/bowel. Although the initial mean adhesion scores were similar for both groups, at second-look laparoscopy the mean adhesion scores were significantly lower for group 2, particularly for ovarian and tubal adhesions. None of the patients formed de novo adhesions. From these results we may conclude that videolaseroscopy: (1) is effective in reducing peritoneal adhesions; (2) is associated with a low frequency of postoperative adhesion recurrence; and (3) appears to completely avoid de novo adhesion formation.