The Role of Laser Technology in Modern Hysteroscopy: Narrative Literature Review of Principles, Clinical Applications, and Current Limitations

Laser technology has recently gained renewed interest in hysteroscopic surgery due to advances in fiber-optic delivery systems, device miniaturization, and the growing adoption of office-based procedures. In this context, laser energy represents a potential alternative to conventional mechanical and electrosurgical techniques, particularly in settings where precision and tissue preservation are clinically relevant. This narrative review provides a comprehensive and clinically oriented overview of the role of laser technology in modern hysteroscopy. A literature search was conducted in PubMed, Scopus, and Web of Science up to December 2025, focusing on studies addressing technical aspects, clinical applications, safety, and outpatient feasibility of laser-assisted hysteroscopy. Different laser systems, including Nd:YAG, diode, CO2, Ho:YAG, and KTP lasers, are discussed in terms of physical properties and tissue interaction. Current clinical applications include the management of intrauterine adhesions, submucous myomas, endometrial polyps, septate uterus, and selected cases of endometrial ablation. Available evidence suggests that modern diode laser platforms are particularly suited for office-based procedures due to their combined cutting and coagulative effects and compatibility with small-caliber hysteroscopes. However, most of the current literature is based on small, heterogeneous studies, and robust comparative data with standard hysteroscopic techniques remain limited. As a result, laser hysteroscopy cannot yet be considered a standard approach across indications. To move beyond a purely technical appraisal, this review also frames laser hysteroscopy as a potential translational platform in which laser–tissue interaction, biomarker-informed patient selection, endometrial repair biology, fertility outcomes, and adhesion-formation mechanisms may be integrated into future functional precision medicine pathways. In conclusion, laser technology represents a promising and evolving tool in operative hysteroscopy, with potential advantages in selected clinical scenarios. Further prospective and comparative studies are required to better define its role and to support its broader integration into routine clinical practice.