Laser excisional conization in an office environment

Use of the laser as an excisional tool in the treatment of cervical disease is an established technique. A study was constructed to determine whether laser excisional conization could be done safely and effectively in an office environment. The subjects of the study were 104 sequential patients who underwent laser excisional cone in an office environment. The average cone size was 16.5 mm by 12.5 mm. The average operating time was 15 minutes. Margins of the cone specimen were adequate for interpretation in 100 patients (96%). Of patients available for complete posttherapy follow-up, 96/98 (98%) achieved initial cure of their lesion. Complications included bleeding requiring revisit in 7.7%, relocation of the SCJ out of colposcopic view in 7%, and cervical stenosis/occlusion in 2 patients. Four pregnancies have occurred and have either been delivered or are progressing satisfactorily. We believe that laser excisional conization may safely and effectively be moved out of the operating room environment.