Pathology of laser tissue welding

Laser tissue welding has been applied successfully to several tissues using microscopic and macroscopic surgical techniques. The advantages of laser tissue welding include the formation of fluid tight bonds, decreased foreign body (suture) reaction scar formation, decreased anastomotic time and growth of the bond. The disadvantages compared to conventional suture and stapling techniques include decreased initial mechanical strengths, poor reproducibility and inadequate control of bond formation. These disadvantages have prevented general acceptance of laser-welding techniques by the general and specialty surgeon. Recently, several laboratories have introduced modified techniques to improve laser tissue welding. These include the use of exogenous dyes and bonding materials to make stronger bonds and computer driven temperature and optical feed-back systems to control bond formation. The advantages provided by the no-touch, fiberoptic delivery of precisely controlled laser light energy to limited endoscopic surgical fields are added reasons to reconsider the usefulness of laser tissue welding.