Experience with the carbon dioxide laser in gynecologic microsurgery.

The value of the carbon dioxide laser in gynecologic microsurgery remains controversial. Initial reports on the success of the laser in infertility surgery were not supported by substantial patient data. The majority of researchers involved with laser microsurgery agree that the technique has numerous advantages, including excellent hemostasis, decreased tissue destruction, exacting precision of dissection and shortened operating time. There are, however, relatively small numbers of patients treated with this modality who have been followed up for a sufficient period of time to determine the ultimate effect the laser will have on pregnancy rates. Since our first laser microsurgical procedure in November, 1980, we have performed more than 150 such procedures. The procedures have included neosalpingostomy, tubal reanastomosis, vaporization of adhesions, and removal of endometriosis. The technique is safe as shown by the absence of any laser-related complication in our cases. We now have 69 patients who have been followed up for more than 1 year since the time of the procedure. The following work is a presentation of pregnancy data and patency rates from this patient group. These results are presented in an effort to offer some objectivity to the comparison of laser microsurgery and standard microsurgery.