Microvascular anastomosis using a new diode laser system with a contact probe.

The aim of the present study was to demonstrate the usefulness of our newly produced diode laser device (an 830-nm output of 190 mW CW) for microvascular end-to-end anastomoses. In the device, diode laser energy is delivered to a contact ceramic tip with a 200-microns diameter output end. Its wavelength is 830 nm and its power 60 mW. This device is small (30 x 25 x 10 cm), lightweight (gross weight 3kg), and easy to manipulate. Compared with conventional microvascular suture anastomosis (CMSA), the time required for the laser-assisted vascular anastomoses (LAVA) was reduced by almost half. Anastomosed portions of both methods were examined 1, 2, 4, 12, and 24 weeks later for patency and aneurysm formation. The patency rate and incidence of aneurysmal formation were the same in both groups. Histological examination revealed that LAVA is superior to CMSA in the smoothness of the inner surface, less inflammatory reaction, and normal collagen and elastic reorientation. The tensile strength and bursting pressure measured immediately after anastomosis demonstrated no significant difference between the two groups. It was concluded that this diode laser contact method may be clinically useful for microvascular surgery.