The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic helium plasma coagulation for the treatment of endometriosis.
It replaces the previous guidance on laparoscopic helium plasma coagulation for the treatment of endometriosis (Interventional Procedures Guidance no. 54, March 2004).
As part of the NICE's work programme, the current guidance was considered for review in June 2009 but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.
Laparoscopic helium plasma coagulation is used to treat endometriosis.
Endometriosis is a common condition. Women with endometriosis have deposits of endometrial tissue, which should be confined to the lining of the uterus, outside the uterus. Symptoms include pelvic pain, dyspareunia, dysmenorrhoea or infertility.
Most women with endometriosis can be treated with analgesia and hormone treatment. Women who do not respond may be offered minimally invasive surgery to excise or vaporise the endometriotic deposits, most commonly by electrocautery or laser through a laparoscope. Women with very severe symptoms may be offered more radical treatment with hysterectomy and removal of the ovaries.
Laparoscopic helium plasma coagulation of endometriosis is another way of vaporising endometrial deposits. Using a laparoscope, an ionised beam of helium gas is directed at endometrial deposits to destroy the affected tissue.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.