Preliminary results with sutured colonic anastomoses reinforced with dye-enhanced fibrinogen and a diode laser

摘要

Abstract: A common cause of morbidity in patients recovering frombowel surgery is leakage from colonic anastomoses. Atechnique utilizing a laser activated protein solder tostrengthen colonic anastomoses in a canine model wasevaluated. Following creation of six single-layerinterrupted suture anastomoses in four dogs, a proteinsolder consisting of indocyanine green dye andfibrinogen was topically appied to the serosal surfaceand exposed to 808 nm continuous wave diode laserenergy. Immediately following anastomosis, the meanleakage pressure of sutures alone was 129 $POM 14 mm hg(n $EQ 6), while the mean leakage pressure of suturesreinforced with the laser welded solder was 312 $POM 32mm hg (n $EQ 6) (p $LS@0.001). Histologic examinationof sections take through the anastomosis demonstrated alayer of fibrinogen across the anastomotic gap withoutevidence of thermal injury. Laser activated proteinsolder significantly enhances the immediate strength ofsutured colonic anastomoses without causing appreciablethermal injury to surrounding tissues.!