Treating bullous lung disease with holmium YAG laser in conjunction with fibrin glue and DEXON™ mesh

Abstract

Background and Objective Holmium YAG (Ho:YAG) laser energy is highly absorbed by water, and this property is useful to uniformly ablate pulmonary bullae. The current study summarizes the data of a 39‐month follow‐up of patients treated for bullae with a Ho:YAG laser. Study Design/Materials and Methods: We used a Ho:YAG laser from August 1994 to April 1997 to treat small pulmonary bullae in 50 patients. For the first five patients, Ho:YAG laser ablation was followed by resection for histological assessment. In the next six patients, fibrin glue was applied following bullae ablation with the Ho:YAG laser. In all subsequent patients, a DEXON™ (polyglycolic acid) mesh patch soaked in fibrin glue was employed after ablation. Results From the six patients receiving only the fibrin glue following laser ablation, delayed pneumothorax developed in one patient. In the subsequent 39 patients patched with DEXON™ mesh soaked in fibrin glue, none encountered delayed pneumothorax. Conclusion The combined use of fibrin glue and Dexon™ mesh with the Ho:YAG laser may be an effective technique for treating bullous lung disease. Lasers Surg. Med. 22:219–222, 1998. © 1998 Wiley‐Liss, Inc.

Surgical management for the prevention of pancreatic fistula following distal pancreatectomy

“…Therefore, continuous exocrine pancreatic secretion from these small pancreatic ducts could lead to a pancreatic fistula after distal pancreatectomy, in spite of the use of fibrin glue. The combined use of fibrin glue and a polyglycolic acid mesh patch is a useful technique for the prevention of air leakage from the lung during thoracic surgery 11. This technique may also be useful for the prevention of pancreatic fistula.…”

Compliance and functional residual capacity after staple versus combined staple/holmium laser lung volume reduction surgery in a rabbit emphysema model

“…Increased morbidity, particularly delayed pneumothorax, has been reported in patients treated with laser LVRS compared with staple LVRS [1]. Prior laser LVRS studies in animals have demonstrated that significant lung injury occurs in normal rabbit lungs with both CO 2 and Nd:YAG laser exposure, though the clinical and histologic presentations were distinct [8,10,11]. Holmium laser exposure is more efficacious but yields no differences in morbidity compared with Nd:YAG and CO 2 exposures [7].…”