Nimble Laser Devices for MIGS

Abstract

Minimally invasive gynecologic surgery (MIGS) has become the standard of care in all developed countries. One of the most notable technical changes in the safe translation of surgeries from the open to laparoscopic arena has been the use of energy, rather than cold steel, to keep the operative field clear of blood. In laparoscopy, we lack the ability to remove blood and other fluids by pressure and sponging; also, we have a more limited ability to apply continuous suction. Consequently, the use of energy in minimally invasive gynecology “comes with the territory.”

Gynecologists operate in close proximity to vital organs and to nonvital but still irreplaceable reproductive tissues. Achieving adequate hemostasis while avoiding excessive thermal injury is one of the main goals of safe gynecologic laparoscopic technique. Expert laparoscopists spend years mastering energy tools and may resist trying radically different energy forms.

The goal of this review is to entice practitioners to reconsider the role of the laser in surgical gynecologic practice in view of the radical technical innovations that have changed the tool in recent years.