Laser assisted vascular welding with real time temperature control

Stewart, Robert B.; Benbrahim, Aziz; LaMuraglia, Glenn M.; Rosenberg, Mark; L’Italien, Gilbert; Abbott, William M.; Kung, R. T. V.

doi:10.1002/(sici)1096-9101(1996)19:1<9::aid-lsm2>3.0.co;2-w

Cited by 49 publications

(47 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[20][21][22][23] The therapeutic window for successful laser tissue welding is relatively large (e.g., 50 to 100°C), allowing for significant error in temperature control without adverse thermal effects in the tissue. However, for the specific application of ONS, the therapeutic window for successfully activating the nerves is much narrower, thus representing a greater challenge.…”

Section: Introductionmentioning

confidence: 99%

Temperature-controlled optical stimulation of the rat prostate cavernous nerves

et al. 2013

View full text Add to dashboard Cite

Abstract. Optical nerve stimulation (ONS) may be useful as a diagnostic tool for intraoperative identification and preservation of the prostate cavernous nerves (CN), responsible for erectile function, during prostate cancer surgery. Successful ONS requires elevating the nerve temperature to within a narrow range (∼42 to 47°C) for nerve activation without thermal damage to the nerve. This preliminary study explores a prototype temperature-controlled optical nerve stimulation (TC-ONS) system for maintaining a constant (AE1°C) nerve temperature during short-term ONS of the rat prostate CNs. A 150-mW, 1455-nm diode laser was operated in continuous-wave mode, with and without temperature control, during stimulation of the rat CNs for 15 to 30 s through a fiber optic probe with a 1-mm-diameter spot. A microcontroller opened and closed an in-line mechanical shutter in response to an infrared sensor, with a predetermined temperature set point. With TC-ONS, higher laser power settings were used to rapidly and safely elevate the CNs to a temperature necessary for a fast intracavernous pressure response, while also preventing excessive temperatures that would otherwise cause thermal damage to the nerve. With further development, TC-ONS may provide a rapid, stable, and safe method for intraoperative identification and preservation of the prostate CNs. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

show abstract

Section: Introductionmentioning

confidence: 99%

Temperature-controlled optical stimulation of the rat prostate cavernous nerves

et al. 2013

View full text Add to dashboard Cite

show abstract

“…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%

“…Diode lasers (λ = 810-988 nm, target water as chromophore) produced supraphysiological welding strength ( Figure 5B) but exhibited full-thickness thermal damage in microvessel LAVA. The thermal damage was associated with an increased rate of thrombosis and aneurysm formation [14,31,34,35]. Diode lasers are therefore more suitable for LAVA of medium-sized vessels.…”

Section: Summary Of Experimental Resultsmentioning

confidence: 99%

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

Pabittei

Boon

Heger

et al. 2015

JCTRes

View full text Add to dashboard Cite

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.

show abstract

“…Some of these instruments are described in [4][5][6][7]. These instruments are similar to the Smart Scalpel in that the feedback signal is a direct measurement of tissue properties.…”

Section: Smart Scalpel Applicationsmentioning

confidence: 99%

Microsurgical laser scalpel based on spectroscopic feedback: the Smart Scalpel

et al. 2001

View full text Add to dashboard Cite

To improve the effectiveness of microsurgical techniques, we have developed a semiautonomous robotic surgical tool (called the "Smart Scalpel") as an alternative approach to the treatment of vascular lesions. The Smart Scalpel employs optical reflectance spectroscopy and computer vision to identify and selectively target blood vessels with a focused treatment laser. Since the laser beam only heats along the blood vessels, collateral damage to adjacent tissue is substantially minimized. The Smart Scalpel also employs rapid real-time feedback analysis for on-line modification of the treatment parameters, quantification of treatment efficacy and compensation for motion tremor. These capabilities allow precise control over the energy d -ieve optimal treatment result. This thesis presents the design of a prototype in , tification of system performance, and methods of image analysis. The thesis will also present results of animal testing and preliminary human studies.

show abstract

Laser assisted vascular welding with real time temperature control

Cited by 49 publications

References 10 publications

Temperature-controlled optical stimulation of the rat prostate cavernous nerves

Temperature-controlled optical stimulation of the rat prostate cavernous nerves

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

Microsurgical laser scalpel based on spectroscopic feedback: the Smart Scalpel

Contact Info

Product

Resources

About