A flexible CO2 laser fiber for operative laparoscopy.

A flexible, hollow fiber measuring 1.5 mm diameter was used in conjunction with the laparoscope to deliver a CO2 laser beam to the rabbit uterine horn. The fibers tested consistently transmitted 5 to 15 W of laser power without loss of input mode. Several fiber-to-target distances were evaluated from the standpoint of crater characteristics. Microscopic sections were studied, and crater heights and widths were quantified. All lesions produced by the CO2 laser fiber closely mimicked those delivered by the free-hand piece or micromanipulator. In two chronic experiments, rapid fibrosis and "filling in" of the craters was evident at 5 days. No adhesions were observed. The CO2 laser fiber has several advantages over current techniques for the performance of laser laparoscopy as well as over alternative systems, e.g., neodymium:yttrium-aluminum-garnet(ND:YAG) and argon-coupled fibers. The CO2 laser fiber will further increase the options available to the gynecologist for operative endoscopy.