Venous and lymphatic anastomosis using a diode laser system

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The usefulness of a new diode laser system(Hamamatsu Photonics Co. Ltd., continuous mode, wavelength; 830nm, ceramic contact probe) for microvascular anastomosis of vein and lymph vessels was studied.The femoral vein of wister rat weighing 250g was transected under microscope and four 10-0 polypropylene stay sutures were placed for edge coaptation. Laser contact probe was touched the anastomotic line to fuse the vein edges 2 - 5 seconds with the power of 60 mW. The laser anastomosis was made in forty rats and the conventional anastomosis with interrupted sutures using 10-0 polypropylene was made in forty rats for control group. The patency was observed for sixteen weeks and the histological examination was also performed in both groups. The anastomosis of lymphatics was made using the lymph vessel in the inguinal region of mongrel dogs(30 - 60 mW, 2 -3 seconds).Patency rates were 95.0% in laser group and 92.5% in control group. Histological examination at two weeks revealed that in laser group intimal cell coverage was completed and the laminar structure of the media was well oriented, on the other hand, in control group, fibrous hyperplasia of the intima and cellular reaction around the suture material were observed. Laser anastomosis of the lymph vessels has technical difficulty to fuse the edges of lymph wall due to penetration or shrinkage of the vessel wall. Furthermore, the histological examination is not enough to observe the change of anastomotic site because of the difficulty to identify the line of anastomosis.Laser amastomosis presents the more physiological wound healing and the characteristic is especially suitable for anastomosis of the veins which are easily thrombosed. Concerning the lymph anastomosis, no satisfactory result was obtained and a new device would be required.