An experimental study of the effects of electrocautery and various lasers on gastrointestinal tissue

It is possible that in the future, lasers will replace electrocautery in gastrointestinal surgical procedures. Few studies exist that compare the tissue effects of electrocautery with newer laser modalities. In this study, the tissue effects of electrocautery, noncontact Nd:YAG, contact Nd:YAG, and CO2 lasers were studied in the stomach, small bowel, colon, liver, and pancreas in 24 rats. At light microscopic examination, all tissue damage was thermal in nature, irrespective of the modality used. Furthermore, an independent observer was unable to distinguish which method has been used in most tissues. Tissue effects were similar in the stomach, small intestine, and colon after use of all the modalities. The CO2 laser caused slightly less damage than the other methods (p less than 0.05), but with use of this modality, hemostasis could not be achieved in the liver and pancreas. The contact Nd:YAG laser caused moderate damage with excellent hemostasis in all tissue. The noncontact Nd:YAG caused significantly more tissue damage than all other methods (p less than 0.01), especially in the liver and pancreas. The results suggest that the new contact laser system provides an effective method of performing gastrointestinal surgery with especially good hemostatic effects on liver and pancreatic resections.