TY - GEN
T1 - Preliminary results of laser tissue welding in extravesical reimplantation of the ureters
AU - Kirsch, Andrew J.M.D.
AU - Milton, Daniel T.
AU - Dean, Gregory E.
AU - Oz, Mehmet C.M.D.
AU - Libutti, Steven K.M.D.
AU - et.al.,
PY - 1993
Y1 - 1993
N2 - One future use of laparoscopic technology is in extravesical reimplantation of the ureters. Technical difficulty arises, however, when intracorporal fine suturing is necessary. We have assessed the efficacy of laser-activated fibrinogen solder to close vesical muscle flaps over submucosal ureters (Lich-Gregoir technique) in a canine model. Four dogs were subjected to unilateral flap closures via a protein solder consisting of indocyanine green and fibrinogen applied to the serosal surface of the bladder and exposed to 808 nm continuous wave diode laser energy. Contralateral reimplantation was performed using 4 - 0 vicryl muscle flap closures and served as controls. Urinary drainage catheters were left in place for 24 hours postoperatively. At 7 (n = 1), 14 (n = 2), and 28 (n = 1) days following reimplantation, intravenous pyelograms confirmed bilateral renal function and ureteral patency. Disruption of wound closures were considered the point of wound dehiscence, vesical diverticulum, or leakage. At intravesical pressures above 100 cm H2O there was no evidence of wound disruption in either of the groups. However, surrounding normal tissue was noted to disrupt. In conclusion, laser-welded vesical wound closures appear at least as strong as suture closures in the canine model.
AB - One future use of laparoscopic technology is in extravesical reimplantation of the ureters. Technical difficulty arises, however, when intracorporal fine suturing is necessary. We have assessed the efficacy of laser-activated fibrinogen solder to close vesical muscle flaps over submucosal ureters (Lich-Gregoir technique) in a canine model. Four dogs were subjected to unilateral flap closures via a protein solder consisting of indocyanine green and fibrinogen applied to the serosal surface of the bladder and exposed to 808 nm continuous wave diode laser energy. Contralateral reimplantation was performed using 4 - 0 vicryl muscle flap closures and served as controls. Urinary drainage catheters were left in place for 24 hours postoperatively. At 7 (n = 1), 14 (n = 2), and 28 (n = 1) days following reimplantation, intravenous pyelograms confirmed bilateral renal function and ureteral patency. Disruption of wound closures were considered the point of wound dehiscence, vesical diverticulum, or leakage. At intravesical pressures above 100 cm H2O there was no evidence of wound disruption in either of the groups. However, surrounding normal tissue was noted to disrupt. In conclusion, laser-welded vesical wound closures appear at least as strong as suture closures in the canine model.
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M3 - Conference contribution
AN - SCOPUS:0027191623
SN - 0819411035
T3 - Proceedings of SPIE - The International Society for Optical Engineering
SP - 168
EP - 174
BT - Proceedings of SPIE - The International Society for Optical Engineering
PB - Publ by Society of Photo-Optical Instrumentation Engineers
T2 - Lasers in Otolaryngology, Dermatology, and Tissue Welding
Y2 - 16 January 1993 through 18 January 1993
ER -