Abstract
A low power carbon dioxide laser was used to perform 110 end-to-end laser-assisted microvascular anastomoses of carotid arteries in ginea pigs and rabbits. In 56 of 72 cases which were irradiated with power output 20-40mW, energy density 1.5-2.5J/mm2, showed patency immediately after surgery with no wound distruption nor thrombus formation. From these results, the optimum condition for anastomosis seemed to be in this range of power output and energy density. The bursting strength of laser-assisted anastomosis (LA) was assessed and compared with conventional suture anastomosis (CA). LA arteries consistently demonstrated lower bursting strength than those of CA. Relatively low bursting strengths at 1 hour and 3 days in the LA with 3 stay sutures may explain the late aneurysm formation. Additional stay suture seemed to prevent such complication. The mean duration of each anastomosis was 13min for the LA repairs compared to an average of 24min for CA repairs. These findings suggest that a low power carbon dioxide laser has potential clinical application for anastomosis of small vessels.
