TY - JOUR
T1 - Sutureless liver repair and hemorrhage control using laser-mediated fusion of human albumin as a solder
AU - Wadia, Yasmin
AU - Xie, Hua
AU - Kajitani, Michio
PY - 2001/7
Y1 - 2001/7
N2 - Background: Major liver trauma has a high mortality because of immediate exsanguination and a delayed morbidity from septicemia, peritonitis, biliary fistulae, and delayed secondary hemorrhage. We evaluated laser soldering using liquid albumin for welding liver injuries. Methods: Fourteen lacerations (6 × 2 cm) and 13 nonanatomic resection injuries (raw surface, 8 × 2 cm) were repaired. An 805-nm laser was used to weld 53% liquid albumin-indocyanine green solder to the liver surface, reinforcing it by welding a free autologous omental scaffold. The animals were heparinized and hepatic inflow occlusion was used for vascular control. For both laceration and resection injuries, 16 soldering repairs were evaluated acutely at 3 hours. Eleven animals were evaluated chronically, two at 2 weeks and nine at 4 weeks. Results: All 27 laser mediated-liver repairs had minimal blood loss compared with the suture controls. No dehiscence, hemorrhage, or bile leakage was seen in any of the laser repairs after 3 hours. All 11 chronic repairs healed without complication. Conclusion: This modality effectively seals the liver surface, joins lacerations with minimal thermal injury, and works independently of the patient's coagulation status.
AB - Background: Major liver trauma has a high mortality because of immediate exsanguination and a delayed morbidity from septicemia, peritonitis, biliary fistulae, and delayed secondary hemorrhage. We evaluated laser soldering using liquid albumin for welding liver injuries. Methods: Fourteen lacerations (6 × 2 cm) and 13 nonanatomic resection injuries (raw surface, 8 × 2 cm) were repaired. An 805-nm laser was used to weld 53% liquid albumin-indocyanine green solder to the liver surface, reinforcing it by welding a free autologous omental scaffold. The animals were heparinized and hepatic inflow occlusion was used for vascular control. For both laceration and resection injuries, 16 soldering repairs were evaluated acutely at 3 hours. Eleven animals were evaluated chronically, two at 2 weeks and nine at 4 weeks. Results: All 27 laser mediated-liver repairs had minimal blood loss compared with the suture controls. No dehiscence, hemorrhage, or bile leakage was seen in any of the laser repairs after 3 hours. All 11 chronic repairs healed without complication. Conclusion: This modality effectively seals the liver surface, joins lacerations with minimal thermal injury, and works independently of the patient's coagulation status.
KW - Albumin solder
KW - Indocyanine green
KW - Liver trauma
KW - Tissue welding
UR - http://www.scopus.com/inward/record.url?scp=0035403831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035403831&partnerID=8YFLogxK
U2 - 10.1097/00005373-200107000-00008
DO - 10.1097/00005373-200107000-00008
M3 - Article
C2 - 11468466
AN - SCOPUS:0035403831
SN - 0022-5282
VL - 51
SP - 51
EP - 59
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 1
ER -