[Lasers in gynecological microsurgery. Comparative experimental study]

Forty Wistar female rats were the subject of a laser resection of the uterine horn with microsurgical anastomosis, comparing the effect of various available lasers with blade section. The animals were divided in four groups. The first group, with 10 animals, underwent a resection of each uterine horn, using the CO2 laser, with a one layer anastomosis using ethilon 10/10, under microscope. Five of them were examined one week later and the five others three weeks later, with evaluation of the adhesions, patency of the anastomosis and its histological examination. The three other groups underwent a resection using an Argon laser, Yag laser or scissors. With the Yag laser, the lumen disappeared completely and the mucosa as well as the musculosa were totally destroyed. In the other groups, adhesions were noted as well as a variable inflammatory reaction, in early and late evaluations. However, this reaction is minimal after a resection with scissors, moderate after CO2 laser, significant after Argon laser. It is concluded that only the CO2 laser is suitable for gynecological microsurgery; however, the only advantage over a scissor resection is a faster operating time and a better hemostasis; the other parameters are in favor of blade resection. Thus, it seems that laser resection is not an ideal procedure in humans, for tubal resection before anastomosis.