Laser therapy: more smoke than light?

Lasers have been used endoscopically in the management of gastrointestinal (GI) diseases for 15 years. Although the initial use was for therapy of GI bleeding, other more portable less expensive modalities have supplanted the laser in this area. Currently, its primary application is for therapy of GI neoplasms. If lasers are to be used with increased frequency, it will require that its unique property--selective absorption--be more of a focus than simply using it as a thermal device. Pigmented vascular lesions such as angioma or watermelon stomach are ideally suited for laser therapy using a wavelength preferentially absorbed by hemoglobin. The future use of lasers for gastrointestinal diseases--both diagnostically and therapeutically--will depend on taking advantage of this unique characteristic of laser light.