Heat-induced tissue fusion for microvascular anastomosis

Cooley, Brian C.

doi:10.1002/(sici)1098-2752(1996)17:4<198::aid-micr6>3.0.co;2-h

Cited by 11 publications

(7 citation statements)

References 42 publications

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“…However, what has proved particularly beneficial is the speed of anastomosis, especially in restricted surgical fields, such as cranial nerve surgery [56]. On the other hand, three significant disadvantages have been identified using LTW: (1) low tensile strength immediately and up to a few days postsurgery, and as a result, many surgeons still employing support sutures; (2) localised thermal damage; and (3) inconsistent, thus unreliable results [4,13,67].…”

Section: Laser Tissue Weldingmentioning

confidence: 99%

Nerve repair: toward a sutureless approach

et al. 2014

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Peripheral nerve repair for complete section injuries employ reconstructive techniques that invariably require sutures in their application. Sutures are unable to seal the nerve, thus incapable of preventing leakage of important intraneural fluids from the regenerating nerve. Furthermore, sutures are technically demanding to apply for direct repairs and often induce detrimental scarring that impedes healing and functional recovery. To overcome these limitations, biocompatible and biodegradable glues have been used to seal and repair peripheral nerves. Although creating a sufficient seal, they can lack flexibility and present infection risks or cytotoxicity. Other adhesive biomaterials have recently emerged into practice that are usually based on proteins such as albumin and collagen or polysaccharides like chitosan. These adhesives form their union to nerve tissue by either photothermal (tissue welding) or photochemical (tissue bonding) activation with laser light. These biomaterial adhesives offer significant advantages over sutures, such as their capacity to unite and seal the epineurium, ease of application, reduced invasiveness and add the potential for drug delivery in situ to facilitate regeneration. This paper reviews a number of different peripheral nerve repair (or reconstructive) techniques currently used clinically and in experimental procedures for nerve injuries with or without tissue deficit.

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Section: Laser Tissue Weldingmentioning

confidence: 99%

Nerve repair: toward a sutureless approach

et al. 2014

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“…However, in most LAVA studies, stay sutures were still employed to support vessel approximation and anastomotic strength ( Figure 4) [2,7,[12][13][14][15][21][22][23]27,31,34,35,38,42,43,46,47,[68][69][70][71]81]. Several studies in which stay sutures were entirely omitted and the vessel segments were adjoined using microforceps, a balloon catheter, or a polyvinyl alcohol splint reported lower patency rates and were not applicable to all vessel sizes [16,17,23].…”

Section: Summary Of Experimental Resultsmentioning

confidence: 99%

“…The superficial absorption of the CO2 laser (λ = 10,600 nm) was more suitable for microvascular anastomoses (Ø ≤ 1 mm). However, when operated in continuous-wave mode, CO2 LAVW was often associated with full-thickness thermal damage and a high rate of aneurysm formation ( Figure 5A) [1,7,12,26,43,70,72,80,81]. LAVW with a pulsed thulium-holmium-chromiumdoped (THC):yttrium-aluminum-garnet (YAG) laser (λ = 2,150 nm, targets water as chromophore), which has an OPD between that of the CO2 and neodymium (Nd):YAG laser (λ = 1,064 nm, also targets water as chromophore), produced sutureless microvascular anastomoses with bursting pressures of 400 ± 55 mmHg, while thermal damage was limited to the adventitia [39].…”

Section: Summary Of Experimental Resultsmentioning

confidence: 99%

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Laser-assisted vessel welding: state of the art and future outlook

Pabittei

Boon

Heger

et al. 2015

JCTRes

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Laser-assisted vascular welding (LAVW) is an experimental technique being developed as an alternative to suture anastomosis. In comparison to mechanical anastomosis, LAVW is less traumatic, non-immunogenic, provides immediate water tight sealant, and possibly a faster and easier procedure for minimally invasive surgery. This review focuses on technical advances to improve welding strength and to reduce thermal damage in LAVW. In terms of welding strength, LAVW has evolved from the photothermally-induced microvascular anastomosis, requiring stay sutures to support welding strength, to sutureless anastomoses of medium-sized vessels, withstanding physiological and supraphysiological pressure. Further improvements in anastomotic strength could be achieved by the use of chromophore-containing albumin solder and the employment of (biocompatible) polymeric scaffolds. The anastomotic strength and the stability of welds achieved with such a modality, referred to as scaffold-and solder-enhanced LAVW (ssLAVW), are dependent on the intermolecular bonding of solder molecules (cohesive bonding) and the bonding between solder and tissue collagen (adhesive bonding). Presently, the challenges of ssLAVW include (1) obtaining an optimal balance between cohesive and adhesive bonding and (2) minimizing thermal damage. The modulation of thermodynamics during welding, the application of semi-solid solder, and the use of a scaffold that supports both cohesive and adhesive strength are essential to improve welding strength and to limit thermal damage.

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“…This is the first study to investigate the healing capacity of MSCs in the treatment of small bowel anastomoses using electronic tissue fusion technology in an in vivo animal 7 Stem Cells International model. Based on our preliminary experiments, we expected better clinical or laboratory outcomes in the present study as compared with those obtained using simple tissue fusion technology [31,32]. Given the nature of the tissue healing process and findings in the literature on grafted stem cell survival, we chose 7 and 14 d as the timepoints postsurgery.…”

Section: Discussionmentioning

confidence: 99%

Mesenchymal Stem Cells Combined with Tissue Fusion Technology Promoted Wound Healing in Porcine Bowel Anastomosis

Pan

Lam

Tong

et al. 2020

Stem Cells International

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Objective. To evaluate the possible biological effect of allogenic mesenchymal stem cells (MSCs) combined with tissue fusion technology on the anastomosis. Methods. Sixteen pigs were divided into a 7 d group and 14 d group, each of which was further subdivided into an MSC-treated group and a control group. Five anastomoses per animal were established using LigaSure ForceTriad (Covidien, MA, USA), a tissue sealing system. Cell migration and tissue-specific differentiation potency, in addition to potential cytokine and genetic changes, were investigated. Results. There were no significant between-group differences in postoperative complications and anastomosis burst pressure. The number of proliferating cell nuclear antigen-(PCNA-) positive cells was significantly higher in the MSC-treated group as compared with that in the control group (P = 0:021). Labeled MSCs were found in the mucosal layer, villus, and lamina propria, as well as in the lamina muscularis mucosae, where they exhibited characteristics of smooth muscle cells. Conclusions. Grafted MSCs significantly promoted epithelial and connective cell proliferation and maintained their cell migration capacity and differentiation potential in the fused anastomotic tissues, without causing severe postoperative complications.

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Heat-induced tissue fusion for microvascular anastomosis

Cited by 11 publications

References 42 publications

Nerve repair: toward a sutureless approach

Nerve repair: toward a sutureless approach

Laser-assisted vessel welding: state of the art and future outlook

Mesenchymal Stem Cells Combined with Tissue Fusion Technology Promoted Wound Healing in Porcine Bowel Anastomosis

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