Endometrial laser ablation in rabbits: a comparative study of three laser types

Endometrial laser ablation is one of the alternatives to hysterectomy in cases of intractable uterine bleeding. It is currently performed using the Nd:YAG laser at 1.06 microns. The aim of this study was to compare the tissue effect of three types of laser irradiation (Nd:YAG laser at 1.06 and 1.32 microns and holmium laser at 2.12 microns) on the rabbit endometrium. Crater formation, coagulation necrosis, and muscle necrosis were evaluated at the time of ablation, as well as at 1 week and 4 weeks postablation. The results were assessed by determining the depth and width of the affected portion in the uterine wall (lumen to serosa). It was shown that Nd:YAG laser at 1.32 microns caused more generalized and extended effects as compared with the other laser types examined. Endometrial regeneration was faster after ablation by the Nd:YAG laser at 1.06 microns and the holmium laser than by the Nd:YAG laser at 1.32 microns. The widest range of "ablation energy" (defined as that causing ablation without muscle damage) was achieved by applying the holmium laser. Further evaluation of the holmium laser for this indication is recommended.