Diode laser-assisted anastomosis of the vas deferens in rats

G. Benaim, R. PiniInstitute of Quantum Electronics, CNR, Florence, ItalyR. Gelli, U.M. Reali, V. GiannottiPlastic and Reconstructive Surgery, Florence University, ItalyABSTRACTWe present the preliminary results of an experimental study on diode laser-assisted end-to-endanastomosis of the vas deferens in rats. Laser irradiation was associated with a photoenhancingchromophore to produce welding of the stumps at low laser power supported by only 2 suture says. Thereduction of suture material is aimed to minimize foreign body reaction during the healing process.1. INTRODUCTIONIn human about 7% of all the cases of azoospermia is due to deferential obstruction. Amongthem, about 50 % of the stenosis are originated by infections or traumatisms after vasectomy1.The surgical therapy that is required in these cases concerns the removal of the stenotic segment(only if the stenotic tract is at last few cm) and the restoration of a pervious lumen by end-to-endanastomosis with interrupted sutures, placed on one or two layers of the vas deferens walls, dependingon the surgical technique employed2. The occurrence of relapses after this therapy is still significantlyhigh, concerning about 50 % of the treated cases34.In our opinion this figure could be improved by reducing or avoiding suture materials by using alaser-assisted welding procedure that could favour a better healing process at the anastomotic site. Thisproposal is based on the positive results obtained by our group in diode laser-assisted microvascularanastomosis (LAMA) of femoral vessels of rats5, that has some similarities with the anastomosis of thevas deferens. In those studies we found that LAMA accomplished without permanent suture staysproduced a very good restoration of the vessel wall structures consequent to the significantly reducedforeign body reaction.In this paper we present a preliminary experimental work where we investigated the possibilityto perform with success diode laser-assisted end-to-end anastomosis of the vas deferens in rats. Clinicaland histological evaluations have been obtained from a follow up procedure extended up to 30 day afterthe treatment.2. MATERIALS AND METHODSThe diode laser system (805 nm emission wavelength, 500 mW power) has been constructed byIEQ for surgery room operations. It is very compact and lightweight (22x25x16 cm, 3 kg.) and includesa fiberoptic delivery system (400 jim core fiber). The welding effect induced by diode laser radiation is