Authors' objectives: The optimal treatment of mild to moderate endometriosis is still in dispute today. This is due to the high number of recurrences of the disease and the adverse effects of hormone therapy. Therefore, the technology continues to advance with the development of new devices. The HELICA surgical technique is a laparoscopic thermal ablation procedure indicated in mild to moderate endometriosis, which can burn to a depth of 1 to 2 mm producing a cutting and coagulation effect with little damage to underlying tissues. A systematic review of the literature recovered a structured literature review (NICE), a low quality randomized clinical trial and eight case series. The case series represent the lowest degree of evidence. With no control group, the effectiveness of the HELICA technique derived from studies with this design can not be determined definitively. The findings on effectiveness of the technique in the clinical trial showed favorable results for the HELICA technique compared with hormonal treatment (GnRH-a) regarding the percentage of asymptomatic women 12 months after completion of treatment (53% vs. 17 %) and the subsequent need for additional treatment (29.5% vs. 66.5%). The case series showed a percentage of symptom relief between 25.3% and 90.3% at 3 and 14 months after surgery. Between 5% and 20% of women had to take GnRH-a at 6 months from the application of the HELICA technique, while between 16% and 18% required surgical re-intervention. Less than 50% of women with fertility problems secondary to endometriosis achieved pregnancy at the end of the study. The percentage for intra and post-operative adverse effects varied between 0.4% and 1.4%. Currently there are no long-term, good quality, clinical trials to demonstrate the safety and long-term effectiveness of the HELICA technique in the treatment of mild to moderate endometriosis compared with other treatment alternatives.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/efectividad-y-seguridad-de-la-tecnica-helica-en-el-tratamiento-de-la-endometriosis/

Year Published: 2011

URL for published report: https://www.aetsa.org/download/publicaciones/antiguas/AETSA_2009-02-2_Helica.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: Andalusian Agency for Health Technology Assessment (AETSA)