CO2 laser-assisted repair of esophageal lacerations

This study was designed to evaluate the feasibility of CO2 laser-assisted repair of esophageal injuries. Nine-millimeter longitudinal incisions were made in the cervical esophagus of 40 Sprague-Dawley rats. The rats were divided into two groups. Twenty rats in Group 1 had their incisions closed in two layers (mucosa and muscularis) with the I.L. Med Unilase microsurgical CO2 laser (LAREL), using 80 mW of power with a spot size of 200 mu (power density = 255). Twenty rats in Group 2 had their incisions closed in two layers using 8-0 Vicryl conventional suture technique (CST). Postoperatively, an intraluminal methylene blue injection evaluated patency and leakage. Histologic analysis was performed at 3 days, 2 weeks, 1 month, and 6 months. Patency rates of LAREL and CST were comparable. No fistulas or strictures were found with either technique. Laser-assisted repair of esophageal lacerations (LAREL) was found to be faster and easier than CST. The question arises whether small esophageal tears can be safely repaired through the endoscope. This study demonstrates the feasibility of tissue welding the esophagus. Further research is mandatory to study the applicability of this technique in the clinical setting.