Esophageal incisions repair by CO2 laser soldering.
OBJECTIVE
This study evaluated the feasibility of fiberoptic CO2 laser soldering for the repair of esophageal injuries under tight temperature feedback control in an animal model. Healing was compared to conventional suture closure.


METHODS
A CO2 soldering system equipped with infrared transmitting silver halide fibers was used. The soldered tissue temperature was monitored continuously, and laser power was adjusted to provide constant temperature. The procedure was done with 50% bovine serum albumin solder. Longitudinal incisions measuring 8 to 10 mm were made under general anesthesia in the cervical esophagus of 25 rats. Twenty rats (group I) underwent laser tissue bonding; 8 of which were tested in a preliminary study to determine optimal laser parameters. In the remaining 5 rats (group II, controls), closure was performed with 1 layer of 6/0 Vicryl sutures. The rats were sacrificed 2, 3, 4, and 6 weeks postoperatively, and the esophagus was examined histologically.


RESULTS
Optimal temperature was found to be 65 to 70 degrees C and optimal exposure time, 150 to 200 seconds. Laser soldering was successful in 9 of the 12 rats (75%) treated under optimal settings; suturing was successful in 4 of the 5 control rats (80%). There were no significant differences between the groups in healing or complication rates.


CONCLUSIONS
These results indicate that the CO2 laser soldering technique is a valid option for the correction of esophageal tears or incisions in rats. The confirmation and extension of these findings in further studies with larger animals may ultimately lead to the routine in vivo use of temperature-controlled laser repair for the esophagus and other organs. This method lends itself to endoscopic bonding of tissues.
Nageris
Ben I
BI
Department of Otolaryngology--Head and Neck Surgery, Rabin Medical Center, Petah Tiqva, Israel. bennyn@clalit.org.il
Zilker
Zeev
Z
Zilker
Maya
M
Kariv
Noam
N
Feinmesser
Rafael
R
Katzir
Abraham
A
D000818:Animals; D002245:Carbon Dioxide / Q000627:therapeutic use; D004939:Esophageal Perforation / Q000601:surgery; D004947:Esophagus / Q000293:injuries* / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D017075:Laser Coagulation; D023421:Models, Animal; D051381:Rats; D017207:Rats, Sprague-Dawley; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology
D002245:Carbon Dioxide