Radiofrequency Surgical Device Versus YAG Laser for Conization: A Comparative Analysis of Surgical Outcomes and Cervical Canal Stenosis

Abstract

Aim:

Uterine conization involves the removal of cone-shaped tissue samples from the cervix to diagnose or treat precancerous or cancerous lesions. This study compared the surgical instruments used for conization: the YAG laser (used until October 2019) and a radiofrequency surgical device (endoCUT from VIO3®, used since November 2019). We aimed to assess whether a change in instrumentation would improve surgical outcomes.

Methods:

We retrospectively analyzed data from 545 first conizations performed between November 2016 and October 2022. Two cases of instrument failure and 11 cases of concurrent procedures were excluded.

Results:

The YAG laser group (YAG, n = 266) had a median operative time of 22 minutes and a median blood loss of 5 mL, with a mean blood loss of 18.20 mL. The radiofrequency group (VIO3, n = 260) demonstrated a significantly shorter operative time (14 minutes, p < 0.05) and lower blood loss (median of 5 mL, mean of 10.29 mL, p = 0.0269) as determined by the Mann–Whitney U test. However, the incidence of cervical canal stenosis was significantly higher in the VIO3 group than in the YAG laser group (2.7% vs. 0.4%, p = 0.036).

Conclusion:

In conization, switching the instrumentation from the YAG laser to a radiofrequency surgical device (endoCUT from VIO3®) significantly reduced the operation time and blood loss but increased cervical canal stenosis. Further studies are required to determine whether radiofrequency surgical devices are useful for conization.