Laser-assisted demucosalized gastrocystoplasty with autoaugmentation in a canine model

Objectives. Laser-assisted autoaugmentation gastrocystoplasty has been perf ormed successfully. Experiments were performed to determine the optimal las er for tissue welding during demucosalized autoaugmentation gastrocystoplas ty using both a 1.9-mu m diode and a 1.32-mu m neodymium:yttrium-aluminum-g arnet (Nd:YAG) laser with and without thermal control. Methods. Autoaugmentation gastrocystoplasty was performed on 18 female mong rel dogs. Anastomoses were performed by either suture or laser welding with a 50% human albumin solution. A 1.9-mu m diode laser was compared with a 1 .32-mu m Nd:YAG laser with and without thermal control. In vivo canine blad der capacity measurements were performed both before gastrocystoplasty and at euthanasia. The animals were studied on days 4 and 14. Samples of the an astomotic area from each group were taken to measure tensile strength. Hist ologic samples were assessed for tissue damage. Results. There was a significant increase in bladder volume in the 4-day gr oup compared with pregastrocystoplasty values. Both the 1.9-mu m diode lase r and suture control dogs with the Irt-day repairs had significantly more t ensile strength than their 4-day counterparts. In contrast, no statistical difference was found between the 4 and 14-day 1.32-mu m Nd:VAC groups. The suture control group had evidence of minor tissue devitalization at the ana stomosis at both 4 and 14 days. The 1.9 and 1.32-mu m laser groups both had evidence of tissue devitalization at 4 and 14 days. The 1.32-mu m laser gr oup had primarily severe tissue injury. The laser groups at 14 days demonst rated an inflammatory reaction that was localized to the albumin. Conclusions. Demucosalized gastrocystoplasty with autoaugmentation can be s afely and successfully performed with a 1.9-mu m diode laser without signif icant differences in tensile strength when compared with suture controls. T he 1.32-mu m Nd:YAG laser can also be successfully used; however, the long- term results appear to be inferior to the 1.9-mu m diode laser. (C) 2000, E lsevier Science Inc.