title: Laser-assisted microvascular anastomosis using CO2 and KTP/532 lasers.
abstract: The milliwatt carbon dioxide (CO2) laser has been shown to be an effective device for performing laser-assisted microvascular anastomosis (LAMA) with consistently high patency rates, minimal tissue disruption, and rapid surgical time as well as the potential for reduced inflammation due to fewer foreign bodies (sutures) in the wound. The purpose of this investigation was to determine the feasibility of using the potassium titanyl phosphate (KTP) laser to perform LAMA and to compare it to CO2 LAMA in both arteries and veins. Patency rates, inflammatory response, and course of healing were evaluated through histological analysis. Twenty-eight rats were divided into two groups, which underwent either CO2 or KTP LAMA and then were sacrificed at 3 days, and 1, 2, 4, 8, and 12 weeks postoperatively. Patency rates for arteries and veins were comparable for both wavelengths (CO2: 100% for arteries, 93% for veins; KTP: 93% for arteries, 93% for veins). Histological grading of inflammation and fibrosis showed no significant difference between the two groups. This study demonstrated the efficacy of using the KTP/532 laser in performing LAMA. We found the KTP and CO2 LAMA to have comparable patterns of tissue damage and course of healing. Although this experiment did not investigate the mechanism(s) of tissue welding, our results suggest that successful LAMA may be independent of wavelength.
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: B R
authors.initials: BR
authors.lastname: Samonte
authors.forename: M P
authors.initials: MP
authors.lastname: Fried
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D002245:Carbon Dioxide; D005260:Female; D005263:Femoral Artery / Q000473:pathology / Q000601:surgery; D005268:Femoral Vein / Q000473:pathology / Q000601:surgery; D005355:Fibrosis; D007249:Inflammation; D053685:Laser Therapy; D008028:Light Coagulation / Q000295:instrumentation / Q000379:methods*; D008833:Microcirculation; D010710:Phosphates; D051381:Rats; D011919:Rats, Inbred Strains; D013524:Surgical Flaps / Q000379:methods; D013536:Suture Techniques; D013927:Thrombosis / Q000209:etiology; D014025:Titanium; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods*
chemical_list: D010710:Phosphates; C064806:potassium titanylphosphate; D002245:Carbon Dioxide; D014025:Titanium