Lasers in gynecology

Lasers are used in gynecology for excising lesions of the cervix, vagina, and vulva. The carbon dioxide laser is most commonly used, offering precision, minimal blood loss, and prevention of strictures. Preoperative diagnostic evaluation and visualization of the lesion is essential. Endoscopic use of the neodymium:yttrium-aluminum-garnet laser through the hysteroscope for excessive uterine bleeding, and laparoscopic use of the CO2 laser for ablation of endometriosis and associated adhesions have been successful. Photoradiation with an argon tunable dye laser has been used to destroy cancer cells containing a hematoporphyrin derivative. Because special skills are required in laser use, criteria establishing qualifications of users have been developed and are recommended for use.