Low power CO2 laser-assisted microvascular anastomosis: an experimental study

Low power CO2 laser-assisted microvascular anastomosis (LAMA) was used for saphenous artery autotransplantation in 40 rabbits. Eighty end-to-end anastomoses were performed by three methods (conventional interrupted suture, stay suture + laser, laser without stay suture). The long term patency rate in the three types of anastomosis is 93%, 93%, and 100%, respectively. The time needed for the laser procedure is half to one-third of that required for the interrupted suture method. The tensile strength of the bonding site can withstand up to 250 mm Hg of arterial pressure. We have demonstrated that the CO2 laser can be used in microvascular anastomosis with or without stay sutures. Aneurysm formation is a potential risk of LAMA. Accurate coaptation of the transected vessel, precise control of laser energy, and minimal area exposed to the laser beam are the key points for further improving anastomotic quality.