First experimental sutureless laser anastomosis of the large bowel: long-term study.
Large bowel anastomoses were successfully performed without sutures on New Zealand white rabbits using 1,064 nm, 0.4-W power pulsating Nd:YAG laser to create tissue welding.


OBJECTIVE
The aim of this study was to assess long-term results of our experimental data and summarize our experimental work on laser colon anastomosis.


METHODS
This experimental study investigated long-term integrity, degree of narrowing, animal body weight change, visual findings, microscopic appearance, and collagen concentration of laser colon anastomoses, compared with those of conventional sutured anastomoses at thirty and ninety postoperative days.


RESULTS
Two animals in the laser group died without leakage. Postsurgical course in all remaining rabbits studied was uneventful. Bursting pressures in the two groups were equivalent, but the laser group exhibited a consistent narrowing tendency. However, laser anastomoses demonstrated fewer and milder adhesions, and animals showed a better recovery of body weight. Histologically, laser anastomoses showed better layer-to-layer reconstitution without foreign body response and with less fibrosis. Difference in collagen (hydroxyproline) concentration did not reach statistical significance.


CONCLUSIONS
The nature of tissue welding via laser remains undefined, but there is definitely a future for laser bowel anastomosis.
Kawahara
M
M
Colorectal Unit, the Third Department of Surgery, University of Tokyo, Japan.
Kuramoto
S
S
Ryan
P
P
Stillwell
R
R
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D003106:Colon / Q000601:surgery*; D005260:Female; D005549:Foreign-Body Reaction; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D011312:Pressure; D011817:Rabbits; D013537:Sutures; D000267:Tissue Adhesions; D014945:Wound Healing