Carbon dioxide laser laparoscopy for endometriosis.

In conclusion, the CO2 laser has been useful for the vaporization and excision of endometriosis through the laparoscope. Removal through the laparoscope, however, requires recognition of the lesion. Microscopic lesions may not be seen through the laparoscope, and deep invasive lesions may be more palpable than visual. Furthermore, small lesions are probably more rapidly coagulated with bipolar electrosurgery or with thermal coagulators (desiccators) than with the laser technique, and lesions of this size do not require the technology associated with lasers. Deep lesions may require laparotomy for recognition prior to excision. Even though the CO2 laser is an excellent and precise tool, bipolar electrosurgical units, bipolar coagulation, unipolar electrosurgical units, thermal coagulators, and fiber-equipped lasers may be more relevant in certain clinical situations. The exact role of all these types of equipment is still developing.