title: Laser-welded endoscopic endoluminal repair of iatrogenic esophageal perforation: an animal model.
abstract: OBJECTIVE
  To test the feasibility of laser tissue welding (LTW) in creating an endoscopic transluminal repair of esophageal perforation.
  
  
  METHODS
  Animal model.
  
  
  METHODS
  A diode laser was used to create an endoluminal rabbit esophageal perforation repair. Burst pressures were compared with open incision, external suture, and external laser-augmented suture closure. Comparisons were performed five times and analyzed with Kruskal-Wallis analysis of variance and a post hoc Dunn method.
  
  
  RESULTS
  The burst threshold of the endoluminal weld (54.78 +/- 5.84 mm Hg) was significantly higher than that of the open incision (6.5 +/- 1.94 mm Hg) and not significantly different than that of the external suture (37.18 +/- 1.97 mm Hg) or the laser-augmented suture group (71.60 +/- 7.58 mm Hg).
  
  
  CONCLUSIONS
  Laser welding is a feasible method of creating endoluminal repairs with burst strengths comparable with external suture repair, which may allow a subset of patients to avoid traditional open approaches. This is the first reported animal model of LTW for endoscopic closure of iatrogenic esophageal perforation.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Bleier
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gratton
authors.forename: Jason M
authors.initials: JM
authors.lastname: Leibowitz
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
authors.forename: Jason G
authors.initials: JG
authors.lastname: Newman
authors.forename: Noam A
authors.initials: NA
authors.lastname: Cohen
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000818:Animals; D004195:Disease Models, Animal; D004724:Endoscopy; D004939:Esophageal Perforation / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007049:Iatrogenic Disease; D053685:Laser Therapy; D008365:Manometry; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D011817:Rabbits; D013536:Suture Techniques; D013718:Tensile Strength
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid