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Proceedings Paper

Reinforcement of high-risk anastomoses using laser-activated protein solders: a clinical study
Author(s): Steven K. Libutti; Marc Bessler; J. Chabot; Lawrence S. Bass; Mehmet Cengiz Oz; Joseph S. Auteri; Andrew J. Kirsch; Roman Nowygrod; Michael R. Treat
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Paper Abstract

Anastomotic leakage or breakdown can result in catastrophic complications and significantly increased post-operative morbidity and mortality. Certain anastomoses are subject to a higher incidence of disruption and are therefore termed high risk. In an attempt to decrease the risk of anastomotic leaks, we reinforced sutured anastomoses with a laser activated protein solder in patients undergoing esophagojejunostomies (n equals 2), lung transplantation (n equals 2), and pancreaticojejunostomies (Whipple procedure, n equals 5). The protein solder was composed of 1.0 ml of a 25% human albumin solution, 1.0 ml of sodium hyaluronate, and 0.1 ml of Cardiogreen dye. This composition was applied to the sutured anastomosis and activated with an 860 nm pulsed diode laser. Drains were placed when appropriate and patients were followed for up to 10 months post-operatively and assessed for clinical signs of anastomotic leaks. Results to data demonstrated that there were no immediate complications as a result of the procedure. Operative time was not significantly lengthened. There were no cases of clinically significant leakage from any of the reinforced anastomoses. Laser activated protein solders may help to reduce the incidence of leakage in high risk anastomoses. Large numbers of patients and longer follow-up is needed however, to draw significant conclusions.

Paper Details

Date Published: 1 July 1993
PDF: 4 pages
Proc. SPIE 1876, Lasers in Otolaryngology, Dermatology, and Tissue Welding, (1 July 1993); doi: 10.1117/12.147026
Show Author Affiliations
Steven K. Libutti, Columbia Univ. College of Physicians and Surgeons (United States)
Marc Bessler, Columbia Univ. College of Physicians and Surgeons (United States)
J. Chabot, Columbia Univ. College of Physicians and Surgeons (United States)
Lawrence S. Bass, Columbia Univ. College of Physicians and Surgeons (United States)
Mehmet Cengiz Oz, Columbia Univ. College of Physicians and Surgeons (United States)
Joseph S. Auteri, Columbia Univ. College of Physicians and Surgeons (United States)
Andrew J. Kirsch, Columbia Univ. College of Physicians and Surgeons (United States)
Roman Nowygrod, Columbia Univ. College of Physicians and Surgeons (United States)
Michael R. Treat, Columbia Univ. College of Physicians and Surgeons (United States)


Published in SPIE Proceedings Vol. 1876:
Lasers in Otolaryngology, Dermatology, and Tissue Welding
R. Rox Anderson; Lawrence S. Bass; Stanley M. Shapshay; John V. White; Rodney A. White, Editor(s)

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