Nd:YAG laser produces endometrial ablation by passing laser energy through bare fibre / clear fluids and coagulating tissue proteins via a thermal effect. The laser energy destroys endometrial tissue to a fairly consistent depth of 4 to 5 mm.

The Nd:YAG laser can also be used to destroy submucous fibroids and polyps during the
ablation procedure.

The uterine distension medium used during Nd:YAG laser ablation does not need to be electrolyte-free as no electrical conduction is involved, and normal saline is commonly used.


       Two laser endometrial ablation techniques are commonly used:

Touch technique: the laser fibre tip is applied lightly to the endometrium surface and is swept across it.

Nontouch technique: the laser tip does not touch the endometrium but is kept within 1 to 5 mm of it.
The laser beam sweeps the endometrium at a perpendicular angle.

Laser endometrial ablation is not commonly used as the machine is expensive and the single-use fibre is also expensive.