Sutureless End‐to‐End bowel anastomosis using Nd:YAG and water‐soluble intralurninal stent

Anthony J. Costello, Douglas E. Johnson, Douglas M. Cromeens, Kenneth I. Wishnow, Andrew C. Von Eschenbach, Jae Ro

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Sutureless end-to-end intestinal anastomoses were successfully constructed in 20 rabbits. A water-soluble intraluminal stent was used to approximate the tissue edges, and the anastomotic seam was lased with 1.06 μm neodymium:YAG (Nd:YAG) laser energy supplied through a hand-held 600-μm gas-cooled noncontact optical fiber. A continuous 5-watt wave of power was applied over periods ranging from 46 to 92 seconds to produce the tissue blanching and shrinkage that indicated a satisfactory tissue weld. Integrity, degree of tissue reaction, and bursting pressures of the anastomoses were compared to those of anastomoses constructed using standard sutured techniques. The results of the two methods were equivalent at 1 to 3 days, but the laser-fused enteric anastomoses showed less inflammatory reaction and greater bursting pressures at 7 and 14 days. Application of a variety of proteinaceous solutions including extracellular matrix materials and epidermal growth factors prior to lasing failed to augment wound healing. We conclude that lasers show promise as reconstructive, in addition to ablative, surgical instruments.

Original languageEnglish (US)
Pages (from-to)179-184
Number of pages6
JournalLasers in Surgery and Medicine
Volume10
Issue number2
DOIs
StatePublished - Jan 1 1990

Keywords

  • Nd
  • YAG laser
  • bowel welding
  • intraluminal stent
  • tissue fusion

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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