Objective: To test the feasibility of laser tissue welding (LTW) in creating an endoscopic transluminal repair of esophageal perforation. Study Design: Animal model. Subjects and Methods: A diode laser was used to create an endoluminal rabbit esophageal perforation repair. Burst pressures were compared with open incision, external suture, and external laser-augmented suture closure. Comparisons were performed five times and analyzed with Kruskal-Wallis analysis of variance and a post hoc Dunn method. Results: The burst threshold of the endoluminal weld (54.78 ± 5.84 mm Hg) was significantly higher than that of the open incision (6.5 ± 1.94 mm Hg) and not significantly different than that of the external suture (37.18 ± 1.97 mm Hg) or the laser-augmented suture group (71.60 ± 7.58 mm Hg). Conclusion: Laser welding is a feasible method of creating endoluminal repairs with burst strengths comparable with external suture repair, which may allow a subset of patients to avoid traditional open approaches. This is the first reported animal model of LTW for endoscopic closure of iatrogenic esophageal perforation.
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