Probe-based confocal laser endomicroscopy aid in detecting endometriosis during surgery: Study

A recent study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology highlighted the potential of probe-based Confocal Laser Endomicroscopy (pCLE) as a transformative tool in diagnosing endometriosis during both conventional and robot-assisted laparoscopic procedures. The study involved 5 women from Hospital Moriah with an average age of 35 to demonstrate the capability of this innovative technique to provide detailed, real-time imaging of cellular structures associated with the condition.

Endometriosis is a chronic gynecological condition marked by debilitating symptoms like dysmenorrhea (painful periods) and dyspareunia (painful intercourse), has traditionally required histological evaluations for definitive diagnosis. This study sought to validate utility of pCLE by complementing its intraoperative imaging with subsequent histological analyses of 214 optical biopsies collected during surgeries.

A major outcome of the research was the creation of a comparative atlas of confocal images, illustrating cellular structures like adipocytes, glandular tissue, and vascular formations associated with endometriosis. Also, surgeons used this atlas to complete a questionnaire by identifying endometriosis-specific structures in confocal images.

The responses revealed encouraging results where surgeons scored an average of over 8 out of 10 in evaluating the utility of this technique, regardless of their familiarity with pCLE. Approximately 63.1% of participants expressed confidence in pCLE which recommends its use for intraoperative diagnostics.

The study highlighted several key benefits of pCLE, including its ability to generate highly detailed, real-time images, which can significantly improve the ability of surgeons to pinpoint endometriosis lesions. The imaging provided clear views of vascular networks, a hallmark of endometriotic tissue, along with other cellular structures that are often challenging to assess with conventional methods.

This research emphasized areas for improvement where challenges like the durability of the device and its cost-effectiveness were identified as barriers to widespread adoption. The outcomes of this study suggests that refining these aspects will be critical to integrate pCLE into routine gynecological practices.

The findings indicated that pCLE could revolutionize the diagnosis and management of endometriosis, particularly in minimally invasive gynecological surgeries. As the method gains further acceptance and undergoes technological improvements, this holds promise for enhancing the diagnostic accuracy and reducing the reliance on time-consuming histological procedures. Overall, this research not only underlined the feasibility of this method but also sets the stage for its broader clinical applications.

Source:

Okita, F., Andres, M. P., Coudry, R. de A., Riccio, L. G. C., Baracat, E. C., & Abrão, M. S. (2024). Confocal Laser Endomicroscopy as a method for assessing endometriosis: A pilot study. In European Journal of Obstetrics & Gynecology and Reproductive Biology (Vol. 302, pp. 225–231). Elsevier BV. https://doi.org/10.1016/j.ejogrb.2024.09.025