Argon laser treatment of bleeding canine gastric ulcers: Limitations and guidelines for endoscopic use

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We systematically evaluated an endoscopically deliverable argon laser with coaxial CO2. The purposes were to determine limitations and guidelines for effective and safe use. In a series of studies, important variables (power, treatment distance, spot size, power density, and/or coaxial CO2 pressure) for treatment of experimental bleeding gastric ulcers in dogs were controlled, and their influence upon treatment efficacy and histologic damage were quantitated. Separate studies via laparotomy and endoscopy were done. Our conclusions were: 1.Much greater power was required to efficiently treat bleeding lesions via the endoscope than at laparotomy.2.The ideal effective treatment range was 1.0–2.0 cm with an argon delivery system of this design. Long treatment distance was restricted by the necessity to maintain adequate CO2 pressure at the target. Short treatment distance and high-power density were dangerous because of an erosive effect producing arterial bleeding, deep tissue injury, and actual vaporization of the gastric wall.3.Argon laser treatment in the presence of gastric overdistension increased histologic damage compared with normal gastric distension.4.High total treatment energy and low animal weights were major determinants of deep tissue damage with the argon laser in the ideal treatment range.5.Using the treatment guidelines of 1–2 cm treatment distance, adequate CO2 at the target, high-power range, and normal gastric distension, argon laser was effective and relatively safe both endoscopically and at laparotomy.