Gastric mucosal dissection using the Nd-YAG laser synthetic sapphire crystal contact probe. Development of an endoscopic method for the treatment of pancreatic pseudocysts.

A canine gastric-ulcer model was developed to evaluate the safety and effectiveness of the neodymium yttrium-aluminum-garnet (Nd-YAG) laser synthetic sapphire crystal contact probe in intraluminal gastric dissection. The purpose of the study was to assess the potential endoscopic application of the Nd-YAG contact probe in cystogastrostomy for the treatment of selected patients with pancreatic pseudocyst. Seven dogs were used in the study. In the first two dogs, full-thickness linear incisions through the gastric wall demonstrated the Nd-YAG contact probe could be used for a full-thickness gastrostomy dissection. In the other five dogs, gastric ulcers were created by injection of morrhuate sodium (5%). Gastric mucosal dissection with the Nd-YAG contact probe was performed without difficulty. Hemostasis was obtained with either the Nd-YAG contact probe or noncontact fiber, and all areas of dissection and ulcer beds healed within 35 days. The Nd-YAG laser contact endoscopic delivery system appears to be a promising technique for intraluminal dissection.