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14 January 1998 1.9-um diode-laser-assisted anastomoses in reconstructive microsurgery: preliminary results in 12 patients
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The authors reported an original 1.9 micrometer diode laser assisted microvascular anastomosis (LAMA) in human. This technique has been applied in 12 patients during reconstructive surgery for digital replantations (n equals 2), for digital revascularizations (n equals 3) and for free flap transfers (n equals 7). Fourteen end-to-end anastomoses (10 arteries, 4 veins) were performed. LAMA were always performed on vessel which did not impede the chance of success of the surgical procedure in case of thrombosis. LAMA was performed with a 1.9 micrometer diode laser after placement of 2 equidistant stitches. The didoes spot was obtained by means of an optic fiber transmitted to the vessel wall via a pencil size hand piece. The used parameters were as followed: spot size equals 400 micrometer, power equals 70 to 220 mW, time equals 0.7 to 2 seconds, mean fluence equals 115 J/cm2. The mechanism involved is a thermal effect on the collagen of the adventitia and media leading to a phenomena which the authors have termed 'heliofusion.' This preliminary trial has permitted to define the modalities of its use in human. The technique is simple, rapid and easily learned. The equipment is not cumbersome, sterilizable and very ergonomic. LAMA does not replace sutures but is complementary, thanks to a reduction in the number of stitches used and to an access to surgical areas which are not easily accessible. This study must be completed by a larger scale study to confirm this technique and its reliability. Others uses could performed on different tissues such as biliary and urinary track, specially under laparoscopic conditions.
© (1998) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Serge R. Mordon, Michel Schoffs, Veronique L. Martinot, Bruno Buys, Philippe Patenotre, Jean Claude Lesage, and Guy Dhelin "1.9-um diode-laser-assisted anastomoses in reconstructive microsurgery: preliminary results in 12 patients", Proc. SPIE 3195, Laser-Tissue Interaction, Tissue Optics, and Laser Welding III, (14 January 1998);

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