Comparative study of different laser systems
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N Bhatta1, K Isaacson, K M Bhatta
1Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston.
Objective:
To review lasers, laser physics, laser-tissue interaction, delivery systems, and their clinical applications relevant to gynecology.
Settings:
Gynecological Service at Massachusetts General Hospital (MGH) and MGH Laser Center.
Interventions:
None.
Design:
Laser literature review and personal experiences of the authors were used to prepare this manuscript.
Conclusions:
Lasers have been used in gynecologic practice for cutting and coagulating purposes. Photodynamic therapy has been used clinically for malignant conditions and is being investigated for dysplastic lesions of the lower genital tract and for endometrial ablation. Laser welding has potential, but further work is required in this field before it finds a clinical application. The main lasers used in gynecology are CO2, neodymium-yttrium aluminum garnet (Nd:YAG), and potassium tatanyl-phosphate-doubled Nd:YAG. Pulsed Ho:YAG laser looks promising, as does diode lasers. Holmium-yttrium aluminum garnet and diode lasers will be soon available commercially. Improvements in delivery systems have increased user friendliness, and more developments in this area are anticipated, for example, a fiber-optic delivery system for CO2 lasers. We believe that enhanced understanding of laser technology will provide unique applications for development in gynecology.