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Diode laser assisted microvascular anastomosis (LAMA) versus control ateral conventional suture microanastomosis (CMA) were performed in 50 rats. The laser source (830 nm) was included into a micromanipulator without optical fiber connection. The beam was directly focused on a deviating mirorgiving a 200 m spot size . The LAMA was performed on the left common carotid by means of 3 laser shots of360 mW power and 8 s exposure time regulated by auto-stop system, the irradiance being 1 146 W/cm2. CMAwas performed on right carotid by means of six 10.0 Ethilon stitches (BV 70, Ethnor, Neuilly, France). Theanastomoses were evaluated by macroscopic controls and Doppler spectral analysis (DO to D60). AfterLAMA, light and scanning electron microscopy visualized the rapid reendothelialization of the anastomoticline with longitudinal migration ofendothelial cells, while the media was repaired by collagen network due totissular fusion. The procedure demonstrated the usefulness and the adaptability of our new laser system. Theprototype, characterized by low weight (2 500 g), small size (30 X 10 X 6 cm), good laser transmission,equipped with feed-back system is well adapted to microsurgery.1. INTRODUCTIONThe laser assisted microvascular anastomosis (LAMA) with diode laser has been evaluated during thelast fewyears. Theywere first experimented in 1989 by Unno and by Oz, the former using a sapphire contactprobe' and the letter a focusing optical system applied on the anastomotic line stained by chromophore2. Theresults were altered by a significant rate ofpseudoaneurysms. On the over hand in 1991 we investigated theuse of a non contact diode laser system3. The anastomosis technique, the Doppler Spectral Analysis, thelight microscopic (LM) and scanning electron microscopic (SEM) results at short (1 month) and long termfollow-up (7 months) were presented in previous paper"5. In this procedure the laser source was connected tothe micromanipulator by means of an optical fibre . |
