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Laser patch welding: experimental study for application to endoscopic closure of bronchopleural fistula, a
1Department of Surgery II, National Defense Medical College, Tokorozawa, Japan.
Background And Objective:
Postoperative bronchopleural fistula is a serious complication following pulmonary resection. To close the bronchopleural fistula, we developed a new method of endoscopic patch welding using laser tissue welding between bronchial tissue and a patch.
Study Design/Materials And Methods:
The feasibility of the laser patch welding was examined by in vitro and in vivo animal experiments. A newly developed carbon monoxide (CO) laser and an Argon ion laser were evaluated. Various tissue membranes and artificial membranes were evaluated as patch materials.
Results:
We found that the combination of expanded polytetrafluoroethylene (e-PTFE; 200 microns in thickness) and the CO laser with contact irradiation method offered the strongest laser patch welding. Using this combination, the irradiation at 400 W/cm2 for 10 seconds resulted in 16-18 g of measured traction strength at the welding spot (2 mm in diameter). The welded e-PTFE patch at bronchial stump remained for 5 weeks.
Conclusion:
Our results encourage use of this novel laser patch technique for clinical applications.