Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

Andrea Etrusco;Giovanni Buzzaccarini;Antonio Simone Laganà;Vito Chiantera;Salvatore Giovanni Vitale;Stefano Angioni;Maurizio Nicola D’Alterio;Luigi Nappi;Felice Sorrentino;Amerigo Vitagliano;Tommaso Difonzo;Gaetano Riemma;Liliana Mereu;Alessandro Favilli;Panagiotis Peitsidis;Antonio D’Amato

2024-01-01

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Abstract

Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the “see and treat” approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452). Results: Eight studies were included in the qualitative analysis for a total of 474 patients undergoing laser hysteroscopic surgery. Eighty-three patients had female genital tract abnormalities, 63 had submucosal leiomyomas, 327 had endometrial polyps, and one patient had a scar pregnancy. Except for leiomyomas, whose technique already included two surgical times at the beginning, only seven patients required a second surgical step. Cumulative rates of intraoperative and postoperative complications of 2.7% and 0.6%, respectively, were reported. Conclusions: Diode laser through “see and treat” hysteroscopy appears to be a safe and effective method. However, additional studies with larger sample sizes and improved designs are needed to consolidate the evidence currently available in the literature.