Closure of rabbit ileum enterotomies with the argon and CO2 lasers: Bursting pressures and histology

✍ Scribed by Jerry W. Vlasak; George E. Kopchok; Rodney A. White

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 552 KB
• Volume: 8
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.1900080513

✦ Synopsis

In this study, we examined short-term strength and histology of experimental argon and COz laser-welded and control-sutured enterotomies in a rabbit model. Longitudinal 1.0-cm enterotomies were closed with the argon laser at 0.5 (n = 10) or 1.0 (n = 10) W power and a spot diameter of 2.8 mm resulting in energy fluences of 230 and 450 J/cm2, respectively. Similar enterotomies were closed using the C02 laser at 0.5 (n = 10) or 1.0 (n = 10) W power and a spot diameter of 1.2 mm, resulting in energy fluences of 1,360 and 2,730 J/cm2. In all closures, continuous wave laser was delivered for 30 seconds. Using a pressuremonitored infusion system with normal saline, the pressure required to burst each weld as well as sutured controls (n = 10) was recorded approximately 1 minute following fusion. Mean bursting pressures for the argon laser at 0.5 W and 1.0 W were 34.1 f 19.4 mm Hg (mean f SD) and 17.3 f 8.3 mm Hg, respectively, and for the COz laser were 23.5 f 12.0 mm Hg and 31.8 f 15.6 mm Hg, respectively. Sutured controls leaked at 45.2 f 12.0 mm Hg. With the exception of argon-laser welds at an energy fluence of 450 J/cm2, which were less than sutured repairs, the bursting pressures for welded closures were not significantly different from the sutured controls (Student's t distribution, P c -05). Histologic examination of both types of welds demonstrated a fibrin and red blood cell coagulum bridging the anastamosis, with some evidence of mild thermal injury at the mucosa. These findings suggest that both the argon and the C02 lasers present an alternative means to suturing in closure of small-bowel enterotomies.