The first application of the carbon dioxide laser in gynecology was reported in 1973 [l]. Since that time extraordinary progress has been witnessed, particularly in areas of laser operative technique. Interestingly these technical achievements in gynecology have not appeared homogeneously, but rather episodically, following intervals of relative inactivity. During the 5 years between 1973 and 1978 only a smattering of papers was published about laser surgery in our specialty. To exemplify this phenomenon I would point to the events of the Third International Congress for Colposcopy and Cervical Pathology, which met in Walt Disney World, Orlando, Florida, during 1978, with an estimated attendance of over 300 obstetricians and gynecologists. Although virtually every world expert specializing in the management of early genital tract neoplasia was in attendance at this meeting, only four papers were presented about the use of the carbon dioxide laser to treat cervical intraepithelial neoplasia. The reception that these "laser papers" received was cool and most people left the meeting with the impression that the laser was a piece of overpriced exotica that had a limited role to play in practical gynecology. Coincidentally, 6 years later, in May 1984, the American Society for Colposcopy and Cervical Pathology and the Gynecologic Laser Society met jointly with over 300 international participants in Walt Disney World, Orlando, Florida. However, on this occasion, the status of the laser in gynecology had drastically changed. During this meeting over 50% of the papers presented dealt with laser surgery, and one had the distinct impression that the single most important advancement for the treatment of lower genital tract neoplasia was the carbon dioxide laser. Not only was laser vaporization extolled as the conservative method of choice to eradicate ectocervical intraepithelial neoplasia, but also the apparent advantages of laser excisional and combination conization to replace classic scalpel procedures were documented and accepted with virtually no criticism.