Closure of rabbit ileum enterotomies with the argon and CO2 lasers: Bursting pressures and histology

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Abstract
In this study, we examined short‐term strength and histology of experimental argon and CO2 laser‐welded and control‐sutured enterotomies in a rabbit model. Longitudinal 1.0‐cm enterotomies were closed with the argon laser at 0.5 (n = 10) or 1.0 (n = 10) W power and a spot diameter of 2.8 mm resulting in energy fluences of 230 and 450 J/cm2, respectively. Similar enterotomies were closed using the CO2 laser at 0.5 (n = 10) or 1.0 (n = 10) W power and a spot diameter of 1.2 mm, resulting in energy fluences of 1,360 and 2,730 J/cm2. In all closures, continuous wave laser was delivered for 30 seconds. Using a pressuremonitored infusion system with normal saline, the pressure required to burst each weld as well as sutured controls (n = 10) was recorded approximately 1 minute following fusion. Mean bursting pressures for the argon laser at 0.5 W and 1.0 W were 34.1 ± 19.4 mm Hg (mean ± SD) and 17.3 ± 8.3 mm Hg, respectively, and for the CO2 laser were 23.5 ± 12.0 mm Hg and 31.8 ± 15.6 mm Hg, respectively. Sutured controls leaked at 45.2 ± 12.0 mm Hg. With the exception of argon‐laser welds at an energy fluence of 450 J/cm2, which were less than sutured repairs, the bursting pressures for welded closures were not significantly different from the sutured controls (Student's t distribution, P < .05). Histologic examination of both types of welds demonstrated a fibrin and red blood cell coagulum bridging the anastamosis, with some evidence of mild thermal injury at the mucosa. These findings suggest that both the argon and the CO2 lasers present an alternative means to suturing in closure of small‐bowel enterotomies.

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