Improved visualisation of endometriosis using a new spectral analysis autoflourescence laparoscopy system: a pilot study

November 2006

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.


Palter S. Improved visualisation of endometriosis using a new spectral analysis autoflourescence laparoscopy system – a pilot study. Fertil Steril 2006;86(Suppl 2):S82.


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