Preliminary experience with laser reinforcement of vascular anastomoses

Mehmet C. Oz, Lawrence S. Bass, Mathew R. Williams, Alan I. Benvenisty, Mark A. Hardy, Steven K. Libutti, Alex Eaton, Michael R. Treat, Roman Nowygrod

Research output: Chapter in Book/Report/Conference proceedingConference contribution

5 Citations (Scopus)

Abstract

Laser tissue soldering techniques allow reinforcement of sutured repairs and may be a useful adjunct in reducing anastomotic bleeding. Initial results of our clinical trial with laser solder reinforcement are reported. Twenty one patients underwent standard polytetraflourethylene (PTFE) graft arteriovenous fistula (AVF) creation. In all patients thrombin soaked gelatin sponges were placed around the anastomoses and in 10 laser reinforcement was accomplished. Three layers were used: KTP (532 nm, power density 4.1 W/cm2, sport size .5 cm), CO2 (10,600 nm, power density 14.1 W/cm2, spot size .3 cm), and diode (805 nm, power density 9.6 2w/cm2, spot size .2 cm). The solder consisting of 0.4 cc hyaluronate, 0.2 cc albumin, and 3 drops of the appropriate laser enhancing dye (fluorescein for KTP, indocyanine green for the diode, water for CO2) was applied to the target tissues prior to laser exposure. The laser was directed over the tissue in a sweeping motion until the solder had desiccated. Several lessons are evident from our experience. First, overexposure to the laser results in solder charring and ineffective reinforcement. Greater laser exposure with less undesired solder damage is achieved if dye is added to the solder. Second, the solder should be spread over the target in a thin layer to facilitate controlled desiccation and tissue bonding. Additional layers can be applied as required. Although improvements in the solder and laser technique are required, these early results demonstrate a potential clinical use for laser soldered reinforcement during vascular anastomoses.

Original languageEnglish (US)
Title of host publicationProceedings of SPIE - The International Society for Optical Engineering
EditorsOon T. Tan, Rodney A. White, John V. White
Pages147-150
Number of pages4
Volume1422
StatePublished - 1991
Externally publishedYes
EventProceedings of Lasers in Dermatology and Tissue Weldings - Los Angeles, CA, USA
Duration: Jan 21 1991Jan 22 1991

Other

OtherProceedings of Lasers in Dermatology and Tissue Weldings
CityLos Angeles, CA, USA
Period1/21/911/22/91

Fingerprint

reinforcement
solders
Soldering alloys
Reinforcement
Lasers
lasers
Tissue
radiant flux density
Diodes
diodes
charring
thrombin
bleeding
soldering
Dye lasers
gelatins
Soldering
Sports
albumins
Grafts

ASJC Scopus subject areas

  • Electrical and Electronic Engineering
  • Condensed Matter Physics

Cite this

Oz, M. C., Bass, L. S., Williams, M. R., Benvenisty, A. I., Hardy, M. A., Libutti, S. K., ... Nowygrod, R. (1991). Preliminary experience with laser reinforcement of vascular anastomoses. In O. T. Tan, R. A. White, & J. V. White (Eds.), Proceedings of SPIE - The International Society for Optical Engineering (Vol. 1422, pp. 147-150)

Preliminary experience with laser reinforcement of vascular anastomoses. / Oz, Mehmet C.; Bass, Lawrence S.; Williams, Mathew R.; Benvenisty, Alan I.; Hardy, Mark A.; Libutti, Steven K.; Eaton, Alex; Treat, Michael R.; Nowygrod, Roman.

Proceedings of SPIE - The International Society for Optical Engineering. ed. / Oon T. Tan; Rodney A. White; John V. White. Vol. 1422 1991. p. 147-150.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Oz, MC, Bass, LS, Williams, MR, Benvenisty, AI, Hardy, MA, Libutti, SK, Eaton, A, Treat, MR & Nowygrod, R 1991, Preliminary experience with laser reinforcement of vascular anastomoses. in OT Tan, RA White & JV White (eds), Proceedings of SPIE - The International Society for Optical Engineering. vol. 1422, pp. 147-150, Proceedings of Lasers in Dermatology and Tissue Weldings, Los Angeles, CA, USA, 1/21/91.
Oz MC, Bass LS, Williams MR, Benvenisty AI, Hardy MA, Libutti SK et al. Preliminary experience with laser reinforcement of vascular anastomoses. In Tan OT, White RA, White JV, editors, Proceedings of SPIE - The International Society for Optical Engineering. Vol. 1422. 1991. p. 147-150
Oz, Mehmet C. ; Bass, Lawrence S. ; Williams, Mathew R. ; Benvenisty, Alan I. ; Hardy, Mark A. ; Libutti, Steven K. ; Eaton, Alex ; Treat, Michael R. ; Nowygrod, Roman. / Preliminary experience with laser reinforcement of vascular anastomoses. Proceedings of SPIE - The International Society for Optical Engineering. editor / Oon T. Tan ; Rodney A. White ; John V. White. Vol. 1422 1991. pp. 147-150
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abstract = "Laser tissue soldering techniques allow reinforcement of sutured repairs and may be a useful adjunct in reducing anastomotic bleeding. Initial results of our clinical trial with laser solder reinforcement are reported. Twenty one patients underwent standard polytetraflourethylene (PTFE) graft arteriovenous fistula (AVF) creation. In all patients thrombin soaked gelatin sponges were placed around the anastomoses and in 10 laser reinforcement was accomplished. Three layers were used: KTP (532 nm, power density 4.1 W/cm2, sport size .5 cm), CO2 (10,600 nm, power density 14.1 W/cm2, spot size .3 cm), and diode (805 nm, power density 9.6 2w/cm2, spot size .2 cm). The solder consisting of 0.4 cc hyaluronate, 0.2 cc albumin, and 3 drops of the appropriate laser enhancing dye (fluorescein for KTP, indocyanine green for the diode, water for CO2) was applied to the target tissues prior to laser exposure. The laser was directed over the tissue in a sweeping motion until the solder had desiccated. Several lessons are evident from our experience. First, overexposure to the laser results in solder charring and ineffective reinforcement. Greater laser exposure with less undesired solder damage is achieved if dye is added to the solder. Second, the solder should be spread over the target in a thin layer to facilitate controlled desiccation and tissue bonding. Additional layers can be applied as required. Although improvements in the solder and laser technique are required, these early results demonstrate a potential clinical use for laser soldered reinforcement during vascular anastomoses.",
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N2 - Laser tissue soldering techniques allow reinforcement of sutured repairs and may be a useful adjunct in reducing anastomotic bleeding. Initial results of our clinical trial with laser solder reinforcement are reported. Twenty one patients underwent standard polytetraflourethylene (PTFE) graft arteriovenous fistula (AVF) creation. In all patients thrombin soaked gelatin sponges were placed around the anastomoses and in 10 laser reinforcement was accomplished. Three layers were used: KTP (532 nm, power density 4.1 W/cm2, sport size .5 cm), CO2 (10,600 nm, power density 14.1 W/cm2, spot size .3 cm), and diode (805 nm, power density 9.6 2w/cm2, spot size .2 cm). The solder consisting of 0.4 cc hyaluronate, 0.2 cc albumin, and 3 drops of the appropriate laser enhancing dye (fluorescein for KTP, indocyanine green for the diode, water for CO2) was applied to the target tissues prior to laser exposure. The laser was directed over the tissue in a sweeping motion until the solder had desiccated. Several lessons are evident from our experience. First, overexposure to the laser results in solder charring and ineffective reinforcement. Greater laser exposure with less undesired solder damage is achieved if dye is added to the solder. Second, the solder should be spread over the target in a thin layer to facilitate controlled desiccation and tissue bonding. Additional layers can be applied as required. Although improvements in the solder and laser technique are required, these early results demonstrate a potential clinical use for laser soldered reinforcement during vascular anastomoses.

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