The CO2 Gynecology laser is equipped with laparoscope and colposcope and capable of treating a vast majority of gynecologic diseases. The CO2 laser is used via laparoscope for conditions such as endometriosis ablation and lysis of pelvic adhesions. Through the colposcope, the CO2 laser is used for vaporization or conization of cervical intraepithelial neoplasia. By using a colposcope, cervical lesions can be removed the laser beam is delivered to the desired site in a very precise way.
A micromanipulator can be used to direct the laser beam and to vaporize the lesion under direct vision with adequate margin and depth. Patients with vaginal lesions (condyloma) can be treated with excision if they have only a single large lesion. Laser vaporization is better suited for multiple and smaller lesions. The laser can be guided via colposcope. Vaporization of vaginal condyloma should not be too deep because condyloma is a surface lesion.
Vaporization of the superficial epithelial layer with at least 1 cm of margin around the lesion is sufficient. The benefit of using the CO2 laser is the ability to treat a large area without causing a scar, or narrowing of the lumen.
Many vulvar lesions have been treated with the CO2 laser. Ablation of the dermis layer is adequate for condyloma. VIN (Vulvar Intraepithelial Neoplasia) lesions require a slightly deeper ablation (2-3 mm). Vaporization of skin that is too deep requires the doctor to be more skilled and cautious. Washing the lesions with 5% acetic acid can assist in identifying the involved areas. Laser ablation should be performed approximately 1 cm beyond the margin of the lesion to decrease recurrence.