Summary
Leakage from colonic anastomoses is a common cause of morbidity in patients recovering from bowel surgery. We evaluated a technique of laser-fibrinogen reinforcement to strengthen colonic anastomoses in a canine model. After creation of eight single-layer interrupted suture anastomoses in six dogs, indocyanine green-dye-enhanced fibrinogen was topically applied to the serosal surface and exposed to 808 mm diode laser energy. Immediately following colonic anastomosis, the mean leakage pressure was 137±22 mm Hg in the group (n=8) using sutures alone and 326±67 mm Hg (P<0.001) in the group (n=8) after the sutured anastomosis was reinforced with lasered-fibrinogen. On histological examination, no evidence of thermal injury to the tissue edges was noted and a layer of fibrinogen bridged the anastomotic gap. Laser dye-enhanced fibrinogen reinforcement significantly enhances the strength of sutured colonic anastomoses without causing appreciable thermal injury to the host tissues.
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Libutti, S.K., Oz, M.C., Forde, K.A. et al. Canine colonic anastomoses reinforced with dye-enhanced fibrinogen and a diode laser. Surg Endosc 4, 97–99 (1990). https://doi.org/10.1007/BF00591269
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DOI: https://doi.org/10.1007/BF00591269