Laser vs. suture nerve anastomosis.

The repair of injured or transected nerves is frequently encountered in head and neck surgery. Recently, CO2 lasers with milliwatt capability and micrometer spot sizes have been developed that may be used in nerve anastomosis. A comparative study was performed between microsuture and CO2 laser repair of transected sciatic nerves in rats. Nerve regeneration was measured in terms of morphology, electrophysiology, and function. Histologic studies revealed no difference in the size and number of regenerated axons, although there was less scar tissue formation at the anastomotic site with the laser repair. EMG and nerve conduction velocity were similar for the two repair methods. Functional recovery, as determined objectively using measurements of gait footprints, showed no difference between suture and laser repair. Laser-repaired nerves did have a higher dehiscence rate, although this problem can probably be prevented by splinting the rats postoperatively. However, laser repair was faster and simpler than suture repair and required less manipulation of the nerve. This study shows laser repair of peripheral nerves is possible with results comparable to conventional microsuture neurorrhaphy. Laser nerve anastomosis may be an effective alternative to suture nerve repair.