Laser treatment in gynecology

Cornelia de Riese

doi:10.1117/12.531631

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13 July 2004 Laser treatment in gynecology

Cornelia de Riese

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Proceedings Volume 5312, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV; (2004) https://doi.org/10.1117/12.531631
Event: Biomedical Optics 2004, 2004, San Jose, CA, United States

Abstract

This presentation is designed as a brief overview of laser use in gynecology, for non-medical researchers involved in development of new laser techniques. The literature of the past decade is reviewed. Differences in penetration, absorption, and suitable delivery media for the beams dictate clinical application. The use of CO₂ laser in the treatment of uterine cervical intraepithelial lesions is well established and indications as well as techniques have not changed over 30 years. The Cochrane Systematic Review from 2000 suggests no obviously superior technique. CO₂ laser ablation of the vagina is also established as a safe treatment modality for VAIN. CO₂ laser permits treatment of lesions with excellent cosmetic and functional results. The treatment of heavy menstrual bleeding by destruction of the endometrial lining using various techniques has been the subject of a 2002 Cochran Database Review. Among the compared treatment modalities are newer and modified laser techniques. Conclusion by reviewers is that outcomes and complication profiles of newer techniques compare favorably with the gold standard of endometrial resection. The ELITT diode laser system is one of the new successful additions. CO₂ laser is also the dominant laser type used with laparoscopy for ablation of endometriotic implants. Myoma coagulation or myolysis with Nd:Yag laser through the laparoscope or hysteroscope is a conservative treatment option. Even MRI guided percutaneous approaches have been described. No long-term data are available.

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Cornelia de Riese "Laser treatment in gynecology", Proc. SPIE 5312, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV, (13 July 2004); https://doi.org/10.1117/12.531631