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1.9 µm diode laser assisted vascular microanastomoses: Experience in 40 clinical procedures
Author(s) -
Leclère Franck Marie P.,
Schoofs Michel,
Buys Bruno,
Mordon Serge R.
Publication year - 2011
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/lsm.21055
Subject(s) - medicine , surgery , anastomosis , microsurgery
Background Since the initial work of Jacobson and Suarez in 1960, microsurgery has evolved greatly. In 2009, we reported our clinical experience with 1.9 µm diode laser‐assisted vascular microanastomoses (LAMA) for free flap reconstruction. In this report, the ongoing study is now expanded to include 11 additional procedures which were analyzed prospectively with a focus on the duration of the LAMA technique. Methods In total, 40 clinical procedures with LAMA have been performed since 2005. Mean follow‐up was 3.3 years (range 0.5–5.5 years). Among those, 11 procedures were performed and prospectively analyzed during the period 2008–2009. LAMA was performed with a 1.9 µm diode laser after placement of equidistant stitches. For vessels size <1.5 mm, the following laser parameters were used: spot size 400 µm, five spots for each wall, power 125 mW, arterial/venous fluence 100/90 J/cm 2 (spot duration 1/0.9 seconds). Results For the last observed 11 procedures, mean occlusion time of the flap arterial and venous anastomoses was 5.4 ± 0.4 and 6.8 ± 0.7 minutes respectively. One anastomosis required a secondary laser application. Arterial and venous patency rates were 100% at the time of surgery. The success rate for the 11 procedures was 100%. The global success rate of the series (97.5%) is discussed and compared with the literature. Conclusion The success rates for reconstructive free flap surgery realized with LAMA appear excellent. Technical innovation will most likely lead to widespread use of the handpiece laser in the operating room. Lasers Surg. Med. 43:293–297, 2011. © 2011 Wiley‐Liss, Inc.