First sutureless closure of a colotomy.

To assess the possibility of laser anastomosis of the colon, experimental laser closure of colotomies was performed. Transverse colotomies (average 20.7 mm) in New Zealand white rabbits (n = 20) were closed with a 1,064-nm Nd:YAG laser at a pulsating 0.5-W wave of power, using guy sutures to approximate the tissue edges. The laser energy was applied through a specially designed hand piece and hand-held 600- μ m gas-cooled noncontact quartz fiber to produce a satisfactory tissue welding. Similar colotomies were closed using a single layer of interrupted sutures of 5-0 Maxon^® (Davis & Geck, Pearl River, NY) in a control group (n=20). Bursting pressure and index of narrowing were recorded immediately after anastomosis and at 1, 4, and 7 days following surgery. Bursting pressure of the laser-welded closure at 1 day was significantly lower than that of the sutured controls (P <0.01); however, all rabbits recovered uneventfully. There was a marked decrease in adhesion formation following laser anastomosis (P < 0.05). Conversely, one control rabbit showed functional stenosis at 4 days. Histologic study revealed an accelerated healing in the laser group. The index of narrowing was significantly higher in the laser group than in the control group (P <0.05). The completely water-sealed laser anastomosis reduces adhesions and is comparable to conventional suture anastomosis of the colon. [ABSTRACT FROM AUTHOR]