Enterotomy fusion with laser energy: preliminary results in rabbit ileum.
The utility of enterotomy closure with the argon and CO2 lasers was examined in New Zealand white rabbit ileum. Thermal properties of 10 argon (0.5 W power for 30 s, energy fluence 230 J/cm2) and 10 CO2 (1.0 W power for 30 s, energy fluence 2700 J/cm2) laser-fused enterotomies were determined during acute fusion experiments using an AGA 782 digital thermographic camera. Healing of the fusions created by the two lasers was subsequently assessed in an additional group of 28 rabbits by comparing three 1.0-cm longitudinal ileal enterotomies, with each rabbit having both types of laser-welded closures and a sutured control. Thermal measurements made from the 10 closures with each laser revealed that the CO2 fusions generated significantly higher temperatures (max. 198 degrees C, mean 106 +/- 37 degrees C, n = 100) than argon (max. 85.2 degrees C, mean 60.5 + 8.1 degrees C, n = 100) p less than 0.001. In the healing studies, four rabbits died from weld failures (one argon and one CO2 disruption, two rabbits with both welds disrupted). Two additional rabbits died at 1 day and one at 10 days for undetermined reasons. The remainder of the animals were sacrificed at 1 (n = 11), 2 (n = 2) and 4 (n = 9) weeks postoperatively. Sutured closures exhibited more granulation tissue and adhesions surrounding the wounds than did welded closures and seven microabscesses were noted adjacent to sutured repairs. One of the CO2 repairs had an abscess at 4 weeks and none of the argon laser fusions had evidence of disruption or abscess.(ABSTRACT TRUNCATED AT 250 WORDS)
Vlasak
J
J
Harbor-UCLA Medical Center, Torrance.
Kopchok
G
G
Dayhovsky
L
L
Grundfest
W
W
White
R A
RA
D000038:Abscess / Q000209:etiology; D000818:Animals; D001128:Argon; D002245:Carbon Dioxide; D003094:Collagen / Q000528:radiation effects; D005549:Foreign-Body Reaction / Q000209:etiology; D007082:Ileum / Q000601:surgery*; D007834:Lasers / Q000145:classification; D008028:Light Coagulation / Q000009:adverse effects; D011817:Rabbits; D013529:Surgical Wound Dehiscence; D013530:Surgical Wound Infection; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000209:etiology; D014945:Wound Healing
D002245:Carbon Dioxide; D001128:Argon; D003094:Collagen