Laser patch welding: experimental study for application to endoscopic closure of bronchopleural fistula, a preliminary report.
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.


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.


CONCLUSIONS
Our results encourage use of this novel laser patch technique for clinical applications.
Sensaki
K
K
Department of Surgery II, National Defense Medical College, Tokorozawa, Japan.
Arai
T
T
Tanaka
S
S
D000818:Animals; D001983:Bronchial Fistula / Q000601:surgery*; D001999:Bronchoscopy; D002248:Carbon Monoxide; D004285:Dogs; D005402:Fistula / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods; D010995:Pleural Diseases / Q000601:surgery*; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D013718:Tensile Strength
D002248:Carbon Monoxide; D011138:Polytetrafluoroethylene