Reinforcement of high-risk anastomoses using laser-activated protein solders: a clinical study

Steven K. Libutti M.D.; Marc Bessler; J. Chabot; Lawrence S. Bass M.D.; Mehmet Cengiz Oz M.D.; Joseph S. Auteri M.D.; Andrew J. Kirsch; Roman Nowygrod M.D.; Michael R. Treat M.D.

doi:10.1117/12.147026

1 July 1993 Reinforcement of high-risk anastomoses using laser-activated protein solders: a clinical study

Steven K. Libutti M.D., Marc Bessler, J. Chabot, Lawrence S. Bass M.D., Mehmet Cengiz Oz M.D., Joseph S. Auteri M.D., Andrew J. Kirsch, Roman Nowygrod M.D., Michael R. Treat M.D.

Author Affiliations +

Proceedings Volume 1876, Lasers in Otolaryngology, Dermatology, and Tissue Welding; (1993) https://doi.org/10.1117/12.147026
Event: OE/LASE'93: Optics, Electro-Optics, and Laser Applications in Scienceand Engineering, 1993, Los Angeles, CA, United States

Abstract

Anastomotic leakage or breakdown can result in catastrophic complications and significantly increased post-operative morbidity and mortality. Certain anastomoses are subject to a higher incidence of disruption and are therefore termed high risk. In an attempt to decrease the risk of anastomotic leaks, we reinforced sutured anastomoses with a laser activated protein solder in patients undergoing esophagojejunostomies (n equals 2), lung transplantation (n equals 2), and pancreaticojejunostomies (Whipple procedure, n equals 5). The protein solder was composed of 1.0 ml of a 25% human albumin solution, 1.0 ml of sodium hyaluronate, and 0.1 ml of Cardiogreen dye. This composition was applied to the sutured anastomosis and activated with an 860 nm pulsed diode laser. Drains were placed when appropriate and patients were followed for up to 10 months post-operatively and assessed for clinical signs of anastomotic leaks. Results to data demonstrated that there were no immediate complications as a result of the procedure. Operative time was not significantly lengthened. There were no cases of clinically significant leakage from any of the reinforced anastomoses. Laser activated protein solders may help to reduce the incidence of leakage in high risk anastomoses. Large numbers of patients and longer follow-up is needed however, to draw significant conclusions.

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Steven K. Libutti M.D., Marc Bessler, J. Chabot, Lawrence S. Bass M.D., Mehmet Cengiz Oz M.D., Joseph S. Auteri M.D., Andrew J. Kirsch, Roman Nowygrod M.D., and Michael R. Treat M.D. "Reinforcement of high-risk anastomoses using laser-activated protein solders: a clinical study", Proc. SPIE 1876, Lasers in Otolaryngology, Dermatology, and Tissue Welding, (1 July 1993); https://doi.org/10.1117/12.147026

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