Lasers in gynaecology - Are they still obsolete? Review of past, present and future applications.

ESGE Special Interest Group ‘Innovations’ Working Group
Facts, views & vision in ObGyn · 2020 · vol. 12(1) , pp. 63–66 · PMID:32696026 · W4293153677
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review analyzes the evolving role of lasers in gynecological surgery, highlighting their renewed applications in minimally invasive procedures and exploring their strengths, weaknesses, opportunities, and threats.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This review examines how laser technology has evolved in gynecologic endoscopy, using a SWOT analysis to compare strengths and limitations across past, current, and emerging minimally invasive uses, with emphasis on applications relevant to endometriosis. It reports that experimental and clinical studies have found lower collateral thermal damage and more precise incision/lesion characteristics for lasers than monopolar electrosurgery, and that in endometrioma management randomized evidence includes earlier and higher recurrence after CO2 vaporization versus ovarian cystectomy, while other ablative approaches are described as potentially better for preserving ovarian reserve (AMH/AFC) than stripping with reduced inflammatory/procoagulant microparticle changes. The review’s limitations are that it synthesizes heterogeneous studies and notes practical barriers that have historically reduced adoption, including cost, availability, maneuverability constraints, and learning curves. Relevance to endometriosis: the paper’s main discussion explicitly covers endometriosis procedures (including endometrioma vaporization/ablation and deep infiltrating endometriosis treated with CO2 laser), and cites multiple endometriosis-focused trials, outcomes, and mechanistic studies.

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Abstract

After the advent and the subsequent gradual disuse of laser technology in gynaecological surgery, in recent years, thanks to technical improvements, this technology is progressively reaffirming itself in various areas of minimally invasive gynaecological surgery ranging from laparoscopy to robotic surgery and hysteroscopy. This paper, through a SWOT (strengths, weaknesses, opportunities and threats) analysis, shows positives and negatives of this technology with particular attention to present and future applications.

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