Laser assisted fusion of the rat stomach: preliminary studies

The purpose of this study was (1) to determine whether rat gastrotomies could be securely closed without sutures by CO2 laser-induced tissue fusion alone and (2) to compare some characteristics (physical, biochemical, histological) of laser-fused gastrotomies with sutured gastrotomies. Following pentobarbital anesthesia a 1.5-cm longitudinal anterior gastrotomy was made in the forestomach of male Sprague-Dawley rats. This wound was closed using either a sutureless tissue weld created by a microscope-mounted CO2 laser (153 W/cm2) (Group I, N = 61) or with a running 6-O polypropylene suture (Group II, N = 58). Animals were sacrificed on Postoperative Days 1, 2, 4, 7, and 11 and the wounds were studied. Survival to scheduled sacrifice was 95% in Group I and 93% in Group II. Although bursting pressure of laser-fused gastrotomies was significantly lower than that of sutured controls on Postoperative Day 1, measurement on subsequent days showed comparable wound strength between the laser and suture groups. Wound hydroxyproline content was significantly higher on Postoperative Day 1 and lower on Postoperative Day 11 in the laser group. Histologic examination of the laser-fused wounds revealed less inflammation and earlier reepithelialization than the sutured wounds, giving the microscopic appearance of a "neater" healing wound. These results suggest that laser-induced fusion is a feasible method of gastrointestinal wound closure which may complement standard suture techniques.