title: 1.9 µm diode laser assisted vascular microanastomoses: Experience in 40 clinical procedures.
abstract: BACKGROUND
  Since the initial work of Jacobson and Suarez in 1960, microsurgery has evolved greatly. In 2009, we reported our clinical experience with 1.9 µm diode laser-assisted vascular microanastomoses (LAMA) for free flap reconstruction. In this report, the ongoing study is now expanded to include 11 additional procedures which were analyzed prospectively with a focus on the duration of the LAMA technique.
  
  
  METHODS
  In total, 40 clinical procedures with LAMA have been performed since 2005. Mean follow-up was 3.3 years (range 0.5-5.5 years). Among those, 11 procedures were performed and prospectively analyzed during the period 2008-2009. LAMA was performed with a 1.9 µm diode laser after placement of equidistant stitches. For vessels size <1.5 mm, the following laser parameters were used: spot size 400 µm, five spots for each wall, power 125 mW, arterial/venous fluence 100/90 J/cm(2) (spot duration 1/0.9 seconds).
  
  
  RESULTS
  For the last observed 11 procedures, mean occlusion time of the flap arterial and venous anastomoses was 5.4 ± 0.4 and 6.8 ± 0.7 minutes respectively. One anastomosis required a secondary laser application. Arterial and venous patency rates were 100% at the time of surgery. The success rate for the 11 procedures was 100%. The global success rate of the series (97.5%) is discussed and compared with the literature.
  
  
  CONCLUSIONS
  The success rates for reconstructive free flap surgery realized with LAMA appear excellent. Technical innovation will most likely lead to widespread use of the handpiece laser in the operating room.
authors.affiliation: Department of Plastic Surgery, Handcenter of Lille University, 96 rue Gustave Delory, 59810 Lille Lesquin, France.
authors.forename: Franck Marie P
authors.initials: FM
authors.lastname: Leclère
authors.forename: Michel
authors.initials: M
authors.lastname: Schoofs
authors.forename: Bruno
authors.initials: B
authors.lastname: Buys
authors.forename: Serge R
authors.initials: SR
authors.lastname: Mordon
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D018570:Risk Assessment; D013524:Surgical Flaps / Q000009:adverse effects* / Q000098:blood supply; D014654:Vascular Patency / Q000502:physiology; D055815:Young Adult