Liver repair and hemorrhage control by using laser soldering of liquid albumin in a porcine model.
OBJECTIVE
We evaluated laser soldering by using liquid albumin for welding liver injuries. Major liver trauma has a high mortality because of immediate exsanguination and a delayed morbidity from septicemia, peritonitis, biliary fistulae, and delayed secondary hemorrhage.


METHODS
Eight laceration (6 x 2 cm) and eight nonanatomic resection injuries (raw surface, 6 x 2 cm) were repaired. An 805-nm laser was used to weld 50% liquid albumin-indocyanine green solder to the liver surface, reinforcing it with a free autologous omental scaffold. The animals were heparinized and hepatic inflow occlusion was used for vascular control. All 16 soldering repairs were evaluated at 3 hours.


RESULTS
All 16 laser mediated liver repairs had minimal blood loss as compared with the suture controls. No dehiscence, hemorrhage, or bile leakage was seen in any of the laser repairs after 3 hours.


CONCLUSIONS
Laser fusion repair of the liver is a reliable technique to gain hemostasis on the raw surface as well as weld lacerations.
Wadia
Y
Y
Oregon Medical Laser Center, Providence St. Vincent Medical Center, Portland, Oregon 97225, USA. yasminwadia@yahoo.com
Xie
H
H
Kajitani
M
M
D000418:Albumins; D000818:Animals; D006470:Hemorrhage / Q000517:prevention & control*; D006498:Hepatectomy; D007208:Indocyanine Green; D022125:Lacerations / Q000601:surgery*; D053685:Laser Therapy; D008099:Liver / Q000293:injuries* / Q000601:surgery; D013552:Swine; D014949:Wounds, Nonpenetrating / Q000601:surgery*
D000418:Albumins; D007208:Indocyanine Green