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Proceedings Paper

Laparoscopic applications of laser-activated tissue glues
Author(s): Lawrence S. Bass; Mehmet Cengiz Oz; Joseph S. Auteri; Matthew R. Williams; Jeffrey Rosen; Steven K. Libutti; Alexander Mellon Eaton; John F. Lontz; Roman Nowygrod; Michael R. Treat
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Paper Abstract

The rapid growth of laparoscopic cholecystectomy and other laparoscopic procedures has created the need for simple, secure techniques for laparoscopic closure without sutures. While laser tissue welding offers one solution to this problem, concerns about adequacy of weld strength and watertightness remain. Tissue solders are proteinaceous materials which are placed on coapted tissue edges of the tissue to be closed or sealed. Laser energy is then applied to fix the glue in place completing the closure. Closure of the choledochotomy following a laparoscopic common duct exploration is one potential application of this technique. Canine longitudinal choledochotomies 5 mm in length were sealed using several laser glues and using the 808 nm diode laser. Saline was then infused until rupture of the closure and peak bursting strength recorded. Fibrinogen glue provided moderately good adhesion but poor burst strength. Handling characteristics were variable. A viscosity adjusted fibrinogen preparation produced good adherence with mean weld strength 264 +/- 7 mm Hg. The clinical endpoint for welding was a whitening and drying of the tissue. New laser solders can provide a watertight choledochotomy closure of adequate immediate strength. This would allow reliable, technically feasible common bile duct exploration via a laparoscopic approach.

Paper Details

Date Published: 1 July 1991
PDF: 5 pages
Proc. SPIE 1421, Lasers in Urology, Laparoscopy, and General Surgery, (1 July 1991); doi: 10.1117/12.43925
Show Author Affiliations
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)
Matthew R. Williams, Columbia Univ. College of Physicians and Surgeons (United States)
Jeffrey Rosen, Columbia Univ. College of Physicians and Surgeons (United States)
Steven K. Libutti, Columbia Univ. College of Physicians and Surgeons (United States)
Alexander Mellon Eaton, Columbia Univ. College of Physicians and Surgeons (United States)
John F. Lontz, 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. 1421:
Lasers in Urology, Laparoscopy, and General Surgery
Graham M. Watson; Rudolf W. Steiner; Joseph J. Pietrafitta, Editor(s)

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