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First sutureless closure of a colotomy: Short-term results of experimental laser anastomosis of the colon

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

To assess the possibility of laser anastomosis of the colon, experimental laser closure of colotomies was performed. Transverse colotomies (average 20.7 mm) in New Zealand white rabbits (n = 20) were closed with a 1,064-nm Nd:YAG laser at a pulsating 0.5-W wave of power, using guy sutures to approximate the tissue edges. The laser energy was applied through a specially designed hand piece and hand-held 600-μ m gas-cooled noncontact quartz fiber to produce a satisfactory tissue welding. Similar colotomies were closed using a single layer of interrupted sutures of 5−0 Maxon ® (Davis & Geck, Pearl River, NY) in a control group (n=20). Bursting pressure and index of narrowing were recorded immediately after anastomosis and at 1, 4, and 7 days following surgery. Bursting pressure of the laser-welded closure at 1 day was significantly lower than that of the sutured controls (P <0.01); however, all rabbits recovered uneventfully. There was a marked decrease in adhesion formation following laser anastomosis (P < 0.05). Conversely, one control rabbit showed functional stenosis at 4 days. Histologic study revealed an accelerated healing in the laser group. The index of narrowing was significantly higher in the laser group than in the control group (P <0.05). The completely water-sealed laser anastomosis reduces adhesions and is comparable to conventional suture anastomosis of the colon.

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References

  1. Rochkind S, Rabau MY, Goldman G, Bar-Nea L, Wiznitzer T. Low-energy CO2 laser intestinal anastomosis: an experimental study. Lasers Surg Med 1988;8:579–83.

    PubMed  CAS  Google Scholar 

  2. Sauer JS, Hinshaw JR, McGuire KP. The first sutureless, laser-welded, end-to-end bowel anastomosis. Lasers Surg Med 1989;9:70–3.

    PubMed  CAS  Google Scholar 

  3. Costello AJ, Johnson DE, Cromeens DM, Wishnow KI, von Eschenbach AC, Ro JY. Sutureless end-toend bowel anastomosis using Nd:YAG and watersoluble intraluminal stent. Lasers Surg Med 1990;10:179–84.

    PubMed  CAS  Google Scholar 

  4. McAdams AJ, Meikle AG, Taylor JO. One layer or two layer colonic anastomoses? Am J Surg1970;120: 546–50.

    PubMed  CAS  Google Scholar 

  5. von Klitzing L, Grosspietzsch R, Klink F, Endell W, Husstedt W, Oberheuser F. Zur operativen Refertilisierung durch Laser-Technik. Fortschr Med 1978;96:357–9.

    PubMed  Google Scholar 

  6. Klink F, Grosspietzsch R, von Klitzing L, Endell W, Husstedt W, Oberheuser F. Animal in vivo studies and in vitro experiments with human tubes for endto-end anastomotic operation by a CO2-laser technique. Fertil Steril 1978;30:100–2.

    PubMed  CAS  Google Scholar 

  7. Jain KK, Gorisch W. Repair of small blood vessels with the neodymium-YAG laser: a preliminary report. Surgery 1979;85:684–8.

    PubMed  CAS  Google Scholar 

  8. White RA, Abergel RP, Lyons R,et al. Biological effects of laser welding on vascular healing. Lasers Surg Med 1986;6:137–41.

    PubMed  CAS  Google Scholar 

  9. Lynne C, Carter M, Morris J, Dew D, Thomsen S, Thomsen C. Laser-assisted vas anastomosis: a preliminary report. Lasers Surg Med 1983;3:261–3.

    PubMed  CAS  Google Scholar 

  10. Merguerian PA, Rabinowitz R. Dismembered non-stented ureteroureterostomy using the carbon dioxide laser in the rabbit: comparison with suture anastomosis. J Urol 1986;136:229–31.

    PubMed  CAS  Google Scholar 

  11. Dempsey DT, Showers D, Valente P, Sterling R, White JV. Tissue fusion of the rat stomach with the CO2 laser. Surg Forum 1987;38:118–20.

    Google Scholar 

  12. Poppas DP, Schlossberg SM, Richmond IL, Gilbert DA, Devine CJ. Laser welding in urethral surgery: improved results with a protein solder. J Urol 1988;139:415–7.

    PubMed  CAS  Google Scholar 

  13. Sauer JS, Rogers DW, Hinshaw JR. Bursting pressures of CO2 laser-welded rabbit ileum. Lasers Surg Med 1986;6:106–9.

    PubMed  CAS  Google Scholar 

  14. Mercer CD, Minich P, Pauli B. Sutureless bowel anastomosis using Nd:YAG laser. Lasers Surg Med 1987;7:503–6.

    PubMed  CAS  Google Scholar 

  15. Cespanyi E, White RA, Lyons R,et al. Preliminary report: a new technique of enterotomy closure using Nd:YAG laser welding compared to suture repair. J Surg Res 1987;42:147–52.

    Article  PubMed  CAS  Google Scholar 

  16. Vlasak JW, Kopchok GE, White RA. Laser-assisted intestinal anastomosis. Lasers Surg Med 1988;8:573–8.

    PubMed  CAS  Google Scholar 

  17. Vlasak JW, Kopchok GE, White RA. Closure of rabbit ileum enterotomies with the Argon and CO2 lasers: bursting pressures and histology. Lasers Surg Med 1988;8:527–32.

    PubMed  CAS  Google Scholar 

  18. Asencio-Arana F, Martinez-Soriano F. Stimulation of the healing of experimental colon anastomoses by low-power lasers. Br J Surg 1988;75:125–7.

    PubMed  CAS  Google Scholar 

  19. Arndt KA, Noe JM, Northam DBC, Itzkan I. Laser therapy: basic concepts and nomenclature. J Am Acad Dermatol 1981;5:649–54.

    Article  PubMed  CAS  Google Scholar 

  20. Nelsen TS, Anders CJ. Dynamic aspects of small intestinal rupture with special consideration of anastomotic strength. Arch Surg 1966;93:309–14.

    PubMed  CAS  Google Scholar 

  21. Schober R, Ulrich F, Sander T, Durselen H, Hessel S. Laser-induced alteration collagen substructure allows microsurgical tissue welding. Science 1986;232:1421–2.

    PubMed  CAS  Google Scholar 

  22. Abergel R, Meeker C, Lam T,et al. Control of connective tissue metabolism by lasers: recent developments and future prospects. J Am Acad Dermatol 1984;11:1142–50.

    Article  PubMed  CAS  Google Scholar 

  23. White RA, Kopchok GE, White GH, Klein SR, Uitto J. Laser vascular anastomotic welding. In: White RA, Grundfest WS, eds. Lasers in cardiovascular diseases. Chicago: Year Book Medical Publishers, Inc., 1987:103–17.

    Google Scholar 

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Authors and Affiliations

  1. Colorectal Unit, St. Vincent's Hospital, Melbourne, Australia

    Shu Kuramoto M.D. & Peter J. Ryan M.S. (Aust.), F.R.A.C.S.

Authors
  1. Shu Kuramoto M.D.
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  2. Peter J. Ryan M.S. (Aust.), F.R.A.C.S.
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Additional information

This work was supported by private sources (Colorectal Service), by the Colorectal Unit Research Fund, and by a research grant from St. Vincent's Hospital.

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Kuramoto, S., Ryan, P.J. First sutureless closure of a colotomy: Short-term results of experimental laser anastomosis of the colon. Dis Colon Rectum 34, 1079–1084 (1991). https://doi.org/10.1007/BF02050065

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  • DOI: https://doi.org/10.1007/BF02050065

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