Key points are not available for this paper at this time.
BACKGROUND AND OBJECTIVE: Laser tissue soldering is a method for bonding of incisions in tissues. A biological solder is spread over the cut, laser radiation heats the solder and the underlying cut edges and the incision is bonded. This method offers many advantages over conventional techniques (e.g., sutures). Past researches have shown that laser soldering, using a single laser, does not provide sufficient strength for bonding of cuts in thick (>1 mm) tissues. This study introduces a novel method for laser soldering of thick tissues, under temperature control, using two lasers, emitting two different wavelengths. STUDY DESIGN/MATERIALS AND METHODS: An experimental system was built, using two lasers: (i) a CO(2) laser, whose radiation heated the upper surface of the tissue and (ii) a GaAs laser that heated an albumin layer under the tissue. An infrared fiber-optic radiometer monitored the temperature of the tissue. All three devices were connected to a computer that controlled the process. A computer simulation was written to optimize the system parameters. The system was tested on tissue phantoms, to validate the simulation and ensure that both the upper and lower sides of the cut were heated, and that the temperature could be controlled on both sides. The system was then used ex vivo to bond longitudinal cuts of lengths ∼12 mm in the esophagi of large farm pigs. RESULTS: The theoretical simulations showed a good stabilization of the temperatures at the upper and lower tissue surfaces at the target values. Experiments on tissue phantom showed a good agreement with these simulations. Incisions in esophagi, removed from large farm pigs, were then successfully bonded. The mean burst pressure was ∼3.6 m of water. CONCLUSIONS: This study demonstrated the capability of soldering cuts in thick tissues, paving the way for new types of surgical applications.
Gabay et al. (Mon,) studied this question.