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Controlled temperature tissue fusion: Argon laser welding of rat intestine in vivo, Part One
Author(s) -
Çilesiz Inci,
Thomsen Sharon,
Welch A. J.
Publication year - 1997
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1997)21:3<269::aid-lsm7>3.0.co;2-o
Subject(s) - laser , welding , anastomosis , materials science , biomedical engineering , in vivo , fibrous joint , surgery , composite material , optics , medicine , biology , physics , microbiology and biotechnology
Background and Objective Thermal denaturation of proteins is recognized as a rate process governed by the local temperature‐time response. Since rate processes are exponential with temperature, laser‐assisted tissue welding was performed with and without temperature feedback control (TFC) to investigate the efficacy of temperature feedback in enhancing the photothermal welding process in vivo. Study Design/Materials and Methods An automated system was developed for temperature feedback controlled laser irradiation. An experimental device incorporating co‐aligned laser delivery and temperature detection was used to perform argon laser welded (with and without TFC) enterotomies. The weld strength and histology of laser welded and control sutured enterotomies were compared in an in vivo rat model. Animals (n = 41) were sacrificed at 1, 3, 7, and 21 days postoperatively, and the anastomotic site was removed for bursting/leaking pressure measurements and histological examination. Results Laser‐welded (with and without TFC) and control sutured anastomoses in surviving animals healed comparably. Some laser‐welded anastomoses without TFC ruptured spontaneously (4 out of 15) leading to the animals' death within the first 24–36 hours postoperatively. None of the animals in the other groups had this problem (control suture 0/6; laser with TFC 1 leak/8). The bursting/leaking pressures of the laser welded anastomoses were not significantly different than those of the sutured controls. Conclusion TFC improves the quality of laser‐welded rat intestinal anastomoses in vivo in the critical first postoperative 36 hours. Lasers Surg. Med. 21:269–277, 1997. © 1997 Wiley‐Liss, Inc.