Laser surgery in gynaecology

Abstract

The word LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. In 1917 in his publication ‘The Quantum Theory of Radiation’ Albert Einstein first described the principle of stimulated emission of radiation but it was not until 1954 that physicists attempted to convert Einstein’s theory into practice. The first working laser was produced in 1960 by Theodore Maiman using a synthetic ruby as the lasering medium, since which time a variety of types of laser have been developed, each with its own range of use depending on its individual wavelength. The three most commonly used surgical lasers are the COz, the neodymiumyttrium-aluminium-garnet (Nd-YAG) and argon lasers. The specific tissue effects of absorption, reflection and transmission depend on the wavelengths of these lasers with the depth of penetration being the major practical difference (Table 1). It can be seen that the Nd-YAG laser has the deepest penetration making it suitable for coagulation of blood vessels and for tissue destruction. By contrast the CO2 laser has the most shallow effect. A further difference lies in the delivery system because the Nd-YAG and argon lasers can be transmitted through flexible fibre optic systems. The CO2 laser on the other hand is delivered to the site of tissue destruction by a series of mirrors in an articulated arm, although recent