A preliminary study on rabbit tubal anastomosis with the Nd-YAG laser.

This is the first report on the use of the Nd-YAG laser in performing tubal end to end anastomosis in rabbit. At first, the optimal intensity of laser exposure was evaluated using histological preparations of tubal ampullary tissues which were exposed in various conditions. It was determined that the most suitable condition was 12 watts/cm2 of energy density of 0.2 second duration and a 0.6mm focal spot. Subsequently, these treatment conditions were applied practically to end end anastomosis of severed tubal ampulla of three rabbits. Four weeks later, the second laparotomy was done to confirm the restoration of tubal patency by chromopertubation in vivo, and to excise the restored tube to study the reconstruction of luminal epithelium histologically by scanning electron microscope. Proven by chromopertubation in vivo, tubal patency was restored in 4 out of 6 tubal samples, but in two, tubes were dehisced at the anastomosed line. By scanning electron microscopic observation of tubal samples in which patency was restored some injury to mucosal epithelial cells was seen at the anastomosed site. It is concluded that the Nd-YAG laser technique is useful in tubal end to end anastomosis of rabbit and accurate placement of tubal stumps is essential to the proper restoration of tubal patency.