Evaluation of the carbon dioxide laser for performance of gastrointestinal myotomies.

Using a conventional carbon dioxide laser set at 8-W continuous-wave energy, a technique was developed in the animal laboratory to incise only the muscularis of the pylorus leaving the mucosa and submucosa intact. Similar esophageal myotomies were performed with less success, due to the rich submucosal venous plexus causing obscuring hemorrhage and to the reapproximation of the longitudinal esophageal muscle over a 3-week period. The technique for esophageal myotomy requires further refinement, but pyloromyotomy appears applicable for controlled human trials.