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KMID : 0350519950480030899
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Journal of Catholic Medical College
1995 Volume.48 No. 3 p.899 ~ p.908
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Experimental Ureteroureterostomy Using Contact Neodymium : Yttrium Aluminum Garnet (Nd : YAG) Laser in Rabbits
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Abstract
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The objective of this study was to define the feasibility of the application of contact neodymium : yttrium aluminum garnet (Nd : YAG) laser to uretercureterostomy in experimental animals. Twenty four rabbits were divided into two groups :
conventional
by sutured ureteroureterostomy (control) group and laser assisted ureteroureterostomy (experimental) group.
The experimental group was redivided into three subgroups based on the different power level of the laser : groupⅠwith 4 watts, groupⅡwith 5 watts, and groupⅢwith 6 watts. Control and each subgroup were assigned with 6 rabbits.
After transecting the left lower ureter, different operations were performed on each group. In the control group, ureteroureterostomies were performed with the conventional suture technique. In the experimental group, ureteroureterostomies were
performed with using the contact Nd : YAG laser (wavelength, 1064 nm) which emitted 0.05 see pulses of 4, 5, and 6 watts power respectively.
A twenty five gauge needle was used as a support for all ureterterostomies. Six weeks after ureteroureterostomies, radiographic study, indigo carmine passage test and histologic evaluation were performed.
The mean±SD time required for the achievement of a ureteroureterostomy for the control group was 15.3±0.9 minutes. For experimental groupⅠ, ⅡandⅢ, they were 2.8±0.3, and 2.1±0.2 minutes respectively. There was a significant difference in
operation time for ureteroureterostomy between control and experimental group (P<0.05).
The radiographic study and indigo carmine passage test showed no statistically significant differences in the grading of caliceal appearance (score) and success rate (patency without leakage) between control and experimental group.
The histologic evaluation revealed that the smooth muscle was replaced by collagen tissue at anastomotic site of ureter in control group, and was replaced by fibroblast and loose fibrous connectivs tissue in experimental group.
Based on these findings, contact Nd :YAG laser with a sapphire tip was thought to be a useful tool in ureteroureterostomy in terms of the speed of performance and consistency in surgical technique and these technique could be applied to clinical
ureteral surgery as well as the laparoscopically reconstructive applications.
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