In vitro large diameter bowel anastomosis using a temperature controlled laser tissue soldering system and albumin stent

Spector, David L.; Rabi, Yaron; Vasserman, Irena; Hardy, A.; Klausner, Joseph M.; Rabau, Micha; Katzir, Abraham

doi:10.1002/lsm.20799

Cited by 23 publications

(16 citation statements)

References 26 publications

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“…The produced heat is essential to bond tissue to solders or chitosan adhesives. Unfortunately, the tissue damage associated with the exothermal absorption of the dye can be detrimental because tissue temperature often exceeds 70°C [16]. At this temperature, albumin and collagen molecules denature and crosslink together.…”

Section: Introductionmentioning

confidence: 99%

Photochemical tissue bonding with chitosan adhesive films

et al. 2010

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BackgroundPhotochemical tissue bonding (PTB) is a promising sutureless technique for tissue repair. PTB is often achieved by applying a solution of rose bengal (RB) between two tissue edges, which are irradiated by a green laser to crosslink collagen fibers with minimal heat production. In this study, RB has been incorporated in chitosan films to create a novel tissue adhesive that is laser-activated.MethodsAdhesive films, based on chitosan and containing ~0.1 wt% RB were manufactured and bonded to calf intestine by a solid state laser (λ = 532 nm, Fluence~110 J/cm2, spot size~0.5 cm). A single-column tensiometer, interfaced with a personal computer, tested the bonding strength. K-type thermocouples recorded the temperature (T) at the adhesive-tissue interface during laser irradiation. Human fibroblasts were also seeded on the adhesive and cultured for 48 hours to assess cell growth.ResultsThe RB-chitosan adhesive bonded firmly to the intestine with adhesion strength of 15 ± 2 kPa, (n = 31). The adhesion strength dropped to 0.5 ± 0.1 (n = 8) kPa when the laser was not applied to the adhesive. The average temperature of the adhesive increased from 26°C to 32°C during laser exposure. Fibroblasts grew confluent on the adhesive without morphological changes.ConclusionA new biocompatible chitosan adhesive has been developed that bonds photochemically to tissue with minimal temperature increase.

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Section: Introductionmentioning

confidence: 99%

Photochemical tissue bonding with chitosan adhesive films

et al. 2010

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“…This real-time system enables the surgeon to halt welding when the corneal surface temperature exceeds 65°C, which was previously found to be the upper limit of the surface temperature in which there is no denaturating photothermal injury to the irradiated cornea [20]. Fibers made of polycrystalline halides are used because they are highly transparent in the mid-infrared range, unlike the standard optical fibers of a Nd:YAG laser [21]. …”

Section: Introductionmentioning

confidence: 99%

CO<sub>2</sub> Laser Welding of Corneal Cuts with Albumin Solder Using Radiometric Temperature Control

Strassmann

Livny²,

Loya³

et al. 2013

Ophthalmic Res

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Purpose: To examine the efficacy and reproducibility of CO₂ laser soldering of corneal cuts using real-time infrared fiber-optic radiometric control of tissue temperature in bovine eyes (in vitro) and to evaluate the duration of this procedure in rabbit eyes (in vivo). Methods: In vitro experiment: a 6-mm central perforating cut was induced in 40 fresh bovine eyes and sealed with a CO₂ laser, with or without albumin soldering, following placement of a single approximating nylon suture. A fiber-optic radiometric temperature control system for the CO₂ laser was used. Leaking pressure and histological findings were analyzed and compared between groups. In vivo experiment: following creation of a central perforation, 6 rabbit eyes were treated with a CO₂ laser with albumin solder and 6 rabbit eyes were treated with 10-0 nylon sutures. The amount of time needed for completion of the procedures was compared. Results: In vitro experiment: effective sealing was achieved by CO₂ laser soldering. Mean (± SD) leaking pressure was 109 ± 30 mm Hg in the bovine corneas treated by the laser with albumin solder compared to 51 ± 7 mm Hg in the sutured control eyes (n = 10 each; p < 0.001). Mean leaking pressures were much lower in the corneal cuts sealed only with the laser without albumin solder (48 ± 12 mm Hg) and in the cuts sealed only with albumin without laser welding (6.3 ± 4 mm Hg) than in the cuts treated with laser welding and albumin solder. In vivo experiment: mean surgical time was 140 ± 17 s in the laser-treated rabbits compared to 330 ± 30 s in the sutured controls (n = 6; p < 0.001). A histopathological study of the rabbit corneas 1 day after laser soldering revealed sealed corneal edges with a small gap bridged by coagulated albumin. The inflammatory reaction was minimal in contrast to the sutured controls. No thermal damage was detected at the wound edges. Conclusions: CO₂ laser soldering combined with the fiber-optic radiometer is an effective, reliable, and rapid tool for the closure of corneal wounds, and holds advantages over conventional suturing in terms of leaking pressure and surgical time.

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“…Oz et al [11], DeCoste et al [12], and Bass et al [13] have shown that ICG is an effective chromophore for this purpose. LTS has been successfully utilized in anastomoses of various tissues including the gastrointestinal tract [14,15], blood vessels [16,17], cartilage [18], skin [19,20], bladder [21], and urethra [22], predominantly in ex vivo and in vivo animal studies.…”

Section: Introductionmentioning

confidence: 99%