Laser-welded endoscopic endoluminal repair of iatrogenic esophageal perforation: an animal model

Otolaryngol Head Neck Surg. 2008 Nov;139(5):713-7. doi: 10.1016/j.otohns.2008.08.006.

Abstract

Objective: To test the feasibility of laser tissue welding (LTW) in creating an endoscopic transluminal repair of esophageal perforation.

Study design: Animal model.

Subjects and methods: A diode laser was used to create an endoluminal rabbit esophageal perforation repair. Burst pressures were compared with open incision, external suture, and external laser-augmented suture closure. Comparisons were performed five times and analyzed with Kruskal-Wallis analysis of variance and a post hoc Dunn method.

Results: The burst threshold of the endoluminal weld (54.78 +/- 5.84 mm Hg) was significantly higher than that of the open incision (6.5 +/- 1.94 mm Hg) and not significantly different than that of the external suture (37.18 +/- 1.97 mm Hg) or the laser-augmented suture group (71.60 +/- 7.58 mm Hg).

Conclusion: Laser welding is a feasible method of creating endoluminal repairs with burst strengths comparable with external suture repair, which may allow a subset of patients to avoid traditional open approaches. This is the first reported animal model of LTW for endoscopic closure of iatrogenic esophageal perforation.

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Animals
  • Disease Models, Animal
  • Endoscopy*
  • Esophageal Perforation / pathology
  • Esophageal Perforation / surgery*
  • Feasibility Studies
  • Hyaluronic Acid / administration & dosage
  • Iatrogenic Disease
  • Laser Therapy*
  • Manometry
  • Mucous Membrane / pathology
  • Mucous Membrane / surgery
  • Rabbits
  • Suture Techniques*
  • Tensile Strength

Substances

  • Adjuvants, Immunologic
  • Hyaluronic Acid