First experimental sutureless end-to-end laser anastomosis of the large bowel |
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Authors: | Dr. Masaki Kawahara M.D. Shu Kuramoto M.D. Peter Ryan M.S. F.R.C.S. F.R.A.C.S. Ross Stillwell M.B.B.S. F.R.C.P.A. |
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Affiliation: | (1) The Colorectal Unit, St. Vincent's Hospital, Melbourne, Australia;(2) The Department of Anatomical Pathology, St. Vincent's Hospital, Melbourne, Australia;(3) The University of Melbourne, Melbourne, Australia;(4) The Third Department of Surgery, University of Tokyo, 3-28-6, Mejirodai, Bunkyo-ku, 112 Tokyo, Japan |
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Abstract: | Completely sutureless end-to-end large bowel anastomoses were successfully created in New Zealand white rabbits (n = 26) by using a low-energy (0.4-W wave of power) Nd:YAG laser to produce welded anastomoses. In this study, the short-term integrity, degree of narrowing, macroscopic appearance, and microscopic findings were compared with those of the conventional interrupted onelayer anastomosis (n = 24) at zero, one, four, and seven days after surgery. Two rabbits in the laser group died from leakage. All remaining animals had an uneventful postoperative course. The bursting pressures in the laser group at zero, one, and four days were lower than those in the control group. The narrowing index of the laser anastomosis was higher than that of the suture anastomosis at four and seven days. However, the laser anastomoses showed fewer adhesions, no instances of bowel obstruction, and histologic healing with less fibrosis. The technique of laser anastomosis presents a promising alternative to suturing in reconstitution of the large bowel. |
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Keywords: | Nd:YAG laser Large bowel anastomosis Tissue welding |
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