Laser-Assisted Tubal Anastomosis

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OBJECTIVE: To determine if laser-assisted anastomosis is superior to microsurgical anastomosis and laser welding for tubal reconstruction. STUDY DESIGN: Sixty uterine tubes from 30 rabbits were transected and then anastomosed with a microsurgical technique, laser welding and laser-assisted anastomosis using a microscope. The rabbits were mated one month postoperatively and examined for implantation sites and adhesion formation three to seven days postpartum. RESULTS: The amount of time required to perform laser-assisted anastomosis as well as laser welding was significantly shorter than for microsurgery. All the tubes withstood the distension pressure of pregnancy with the exception of 1 of the 20 laser-welded tubes, which had 30% of its circumference dehisced. There was no difference in the number of implantation sites per tube between the different groups. The anastomotic sites were well healed and were nonidentifiable except for holding stitches and microsurgical sutures. CONCLUSION: Laser-assisted anastomosis and laser welding took less time to perform than microsurgery. Laser-assisted anastomosis resulted in excellent healing, as did microsurgery. With the protection of serum albumin, laser-assisted anastomosis did not cause any thermal damage, and the anastomotic sites could tolerate the distension pressure of pregnancy and parturition without problems. Laser welding without protection of serum albumin could cause thermal damage and dehiscence. The implantation and pregnancy rates were comparable The implantation and pregnancy rates were comparable with all three types of procedure.

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