Endoscopy Guided Photoablation of Endometrial Cysts using a 980 nm Laser with a Contact Fiber in Mares.

This research investigates a less invasive and potentially more effective approach to treating endometrial cysts in horses using laser therapy. The technique is suggested to not only promote easier ultrasound pregnancy diagnosis but also to potentially aid in normal embryo development, without causing harm to the endometrium.

Overview and Introduction

• The study aims to explore a new technique of addressing endometrial cysts in mares associated with endometriosis, a condition that can complicate or delay pregnancy diagnoses. The traditional treatments are found to be invasive and potentially harmful to the endometrium, which is vital for the reproductive health of the mares.
• Using hysteroscopically guided laser therapy for endometrial cyst resection proves to be effective and less intrusive. It does not bear apparent negative effects on the endometrium–a key advantage over traditional treatments.

Procedure and Treatment

• A long, narrow, sterile endoscope is introduced into the uterus through an open cervix of a mare in heat, post clean-up of the vulvar.
• The uterus is mildly infused with less than 1L of a physiological solution, and a laser fiber is inserted into the biopsy canal of the endoscope. Here, cysts are then cauterized using a fiber-set 980 nm diode laser in a continuous mode.
• Each cyst is carefully punctured, ultimately voiding the cyst completely and leading to the cyst wall shrinking around the fiber. Post-surgery, uterine lavages with sterile saline solution are carried out for one to two days until no inflammatory fluid is detected.

Results and Possible Implications

• The technique is swiftly executed and relatively simple to administer for medical professionals. It doesn’t seem to have any deleterious effects and enhances ultrasound pregnancy diagnosis.
• The method could potentially restore the normal trajectory of embryo migration in the uterine horns between day 6.5 and 17. However, it is essential to note that it does not improve the underlying histological lesions related to endometriosis.
• These findings need to be explained clearly to horse breeders before the procedure is undertaken due to the limitations in treating endometriosis fully.