Tight contact technique during side-to-side laser tissue soldering of rabbit aortas improves tensile strength

Alfieri, Alex; Bregy, Amadé; Constantinescu, Mihai A.; Stuker, F.; Schaffner, Thomas; Frenz, Martin; Banič, Andrej; Reinert, Michael

doi:10.1007/978-3-211-76589-0_16

Cited by 7 publications

(15 citation statements)

References 45 publications

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“…New developments in laser anastomosis are being developed, which require a laser probe to be inserted into the artery. 19,20 This has previously tried through cannulating side branches of the artery; however, this is often difficult due to the size and location of appropriate arteries. With the design of the VRAM flap in this study, it is possible to cannulate the DIEA and pass the probe proximally through the entire length of the flap until it emerges at the divided DSEA.…”

Section: Discussionmentioning

confidence: 99%

Focused Arterial Anastomotic Assessment in a Novel Univariate Design of a Vertical Rectus Abdominis Muscle Flap in a Pig Model

Fischlin

Mbaidjol

Olariu

et al. 2017

J Reconstr Microsurg Open

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Background Microsurgical anastomosis is the basis for free tissue transfer. The goal of this study was to create an animal model that mimics free tissue transfer but would focus on the arterial anastomotic assessment alone, without additional bias of a venous anastomosis. Methods A vertical rectus abdominis musculocutaneous (VRAM) flap based on the left deep superior epigastric artery (DSEA) was raised in six large white pigs. The right DSEA was raised and used as the donor vessel. An arterial end-to-end microsurgical anastomosis was then performed between the right and the left SEA artery. The lateral deep epigastric vein (DIEV) was left intact to drain the flap. Perfusion of the flap was confirmed clinically by laser Doppler and by flowmetry. Results One flap failure was observed in this study that occurred on postoperative day (POD) 5 as a consequence of venous occlusion due to hematoma. There was a significant initial drop in arterial flow across the anastomosis in comparison to preanastomotic flow measurements (p < 0.05); however, this was normalized by the seventh POD (p > 0.05). Flow measurements in the vein significantly increased after the arterial anastomosis was completed and the seventh POD (p < 0.05). Laser Doppler assessment demonstrated adequate tissue perfusion of the skin island flap. Conclusion This modified VRAM flap is a viable procedure to simulate a free flap transfer and assess the arterial anastomosis alone, while maintaining the flap's innate venous drainage. This method can allow the investigation of new arterial anastomosis techniques and devices.

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Section: Discussionmentioning

confidence: 99%

Focused Arterial Anastomotic Assessment in a Novel Univariate Design of a Vertical Rectus Abdominis Muscle Flap in a Pig Model

Fischlin

Mbaidjol

Olariu

et al. 2017

J Reconstr Microsurg Open

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“…Furthermore, the flexibility of the scaffold is more favorable for vascular applications than solid solder films [58]. ssLAVW comprises the use of a polymeric scaffold to enhance cohesive bonding of the liquid solder during sLAVW [93][94][95][96][97][98][99][100][101][102][103]108]. A semi-porous scaffold composed of biocompatible polymeric material is drenched in chromophore-containing solder, placed over the coaptation, and irradiated.…”

Section: Drawbacks Of Slavwmentioning

confidence: 99%

“…phore concentrations as a function of welding strength, respectively. The majority of ssLAVW studies were performed in vitro as ssLAVR of small-and medium-sized vessels and used either a 670-nm or an 806-810-nm diode laser [86,[93][94][95][96][97][98][99][100][101][102][103]. Figure 9 shows the improvement in welding strength with increasing power and irradiance.…”

Section: Laser-scaffold Interactionsmentioning

confidence: 99%

“…Figure 11 demonstrates the influence of solder composition and the scaffold's thermo-mechanical properties on acute and post-hydration welding strength. As with sLAVR, a higher solder protein concentration produced stronger repairs than lower protein concentrations [91,93,94,98,102,103,104]. The reduction in solder leakage was achieved by semi-solidification of the solder.…”

Section: Laser-scaffold Interactionsmentioning

confidence: 99%

“…Scanning electron microscopy (SEM) analysis revealed a water-induced loosening of cohesive and adhesive bonds in post-hydration PLGA ssLAVRed aortas. The stability [91,93,94,103,104] and 670-nm [86,98] diode lasers. ssLAVR in B,C, and D were performed with a 670-nm diode laser.…”

Section: Laser-scaffold Interactionsmentioning

confidence: 99%

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Laser-assisted vessel welding: state of the art and future outlook

Pabittei

Boon

Heger

et al. 2015

JCTRes

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Laser-assisted vascular welding (LAVW) is an experimental technique being developed as an alternative to suture anastomosis. In comparison to mechanical anastomosis, LAVW is less traumatic, non-immunogenic, provides immediate water tight sealant, and possibly a faster and easier procedure for minimally invasive surgery. This review focuses on technical advances to improve welding strength and to reduce thermal damage in LAVW. In terms of welding strength, LAVW has evolved from the photothermally-induced microvascular anastomosis, requiring stay sutures to support welding strength, to sutureless anastomoses of medium-sized vessels, withstanding physiological and supraphysiological pressure. Further improvements in anastomotic strength could be achieved by the use of chromophore-containing albumin solder and the employment of (biocompatible) polymeric scaffolds. The anastomotic strength and the stability of welds achieved with such a modality, referred to as scaffold-and solder-enhanced LAVW (ssLAVW), are dependent on the intermolecular bonding of solder molecules (cohesive bonding) and the bonding between solder and tissue collagen (adhesive bonding). Presently, the challenges of ssLAVW include (1) obtaining an optimal balance between cohesive and adhesive bonding and (2) minimizing thermal damage. The modulation of thermodynamics during welding, the application of semi-solid solder, and the use of a scaffold that supports both cohesive and adhesive strength are essential to improve welding strength and to limit thermal damage.

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New laser soldering-based closures: a promising method in natural orifice transluminal endoscopic surgery

Bogni

Ortner

Vajtai

et al. 2012

Gastrointestinal Endoscopy

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Tight contact technique during side-to-side laser tissue soldering of rabbit aortas improves tensile strength

Cited by 7 publications

References 45 publications

Focused Arterial Anastomotic Assessment in a Novel Univariate Design of a Vertical Rectus Abdominis Muscle Flap in a Pig Model

Focused Arterial Anastomotic Assessment in a Novel Univariate Design of a Vertical Rectus Abdominis Muscle Flap in a Pig Model

Laser-assisted vessel welding: state of the art and future outlook

New laser soldering-based closures: a promising method in natural orifice transluminal endoscopic surgery

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