Improvement of the intrauterine laser delivery for endometrial ablation using the side-fire laser fiber

Abstract

With the development of optical fibers capable of transmitting laser energy, lasers have steadily gained acceptance over the last decade for use in performing endoscopic and hysteroscopic surgical procedures. One such laser, the Nd-YAG, is particularly well suited for photocoagulation of the endometrium as a result of its high power and transmission ability through fibreoptics. The advent of hysteroscopic laser surgery has provided an alternative to hysterectomy in women with menorrhagia refractory to other forms of treatment. Experience in patients treated hysteroscopically with a Nd-YAG laser has demonstrated that excellent results were achieved.

We have started to use the side fire laser delivery fiber in combination with the bare fiber for optimization of the laser energy delivery during the endometrial ablation. This trial provided an ideal intrauterine laser energy delivery according to the uterine cavity geometry and light dosimetery distribution. The duration of technique was markedly shorter (average 25 min) than using only the bare fiber and the endometrial coagulation was efficient.