Experimental laser anastomosis of the large bowel: conclusive results and future prospect

Completely sutureless end-to-end large bowel anastomoses were successfully performed in New Zealand white rabbits by using 1064 nm, 0.4-W power pulsating Nd:YAG laser to produce welding. Purpose: The aim of this study was to assess the results of our whole experimental data and summarize our experimental work on laser colon anastomosis. Methods: This experimental study investigated integrity of anastomosis, degree of narrowing, macroscopic appearance, microscopic findings, animal body weight change, and collagen concentration of laser colon anastomoses, compared with those of conventional sutured anastomoses up to ninety postoperative days. Results: Bursting pressures of laser anastomoses were at first low and came to be equivalent at seven days, but the laser group exhibited a consistent narrowing tendency. However, laser anastomoses demonstrated fewer and milder adhesions, and animals showed a better recovery of body weight. Histologically, laser anastomoses showed better layer-to-layer reconstitution without foreign body response and with less fibrosis. Difference in collagen concentration did not reach statistical significance. Conclusion: The technique of laser anastomosis presents a promising alternative to suturing in reconstitution of the large bowel.