title: Experimental evaluation of a new system for laser tissue welding applied on damaged lungs.
abstract: OBJECTIVE
  Alveolar air leaks represent a challenging problem in thoracic surgery, leading to increased patient morbidity and prolonged hospitalization. Several methods have been used, but no ideal technique exists yet. We investigated the lung-sealing capacity of an experimental kit for laser tissue welding.
  
  
  METHODS
  The kit is composed of a semiconductor laser system applied on a protein substrate associated with a chromophore that increases absorption. In vitro tests on porcine lung tissue were done to define ideal laser parameters (power 100 Å, frequency 50 Hz, pulse duration 400 µs) and protein substrate dilution (50%). For in vivo tests, through a left thoracotomy, 14 pigs received two different lung damages: a linear incision and a circular incision. Protein substrate applied on damaged areas was treated with laser to obtain a layer that reconstituted the integrity of the visceral pleura. Air leaks were intraoperatively evaluated by water submersion test with an airway pressure of 20 cmH2O. Animals were sacrificed at postoperative days 0 and 7 to study early and late pathological features.
  
  
  RESULTS
  After applying laser treatment, no air leaks were seen in all proofs except in 2 cases in which a second application was required. At time 0, pathological damage mostly consisted of superficial alveolar necrotic tissue covered by protein membrane. At time 7, a complete recovery of lung lesions by fibrous scar with slight inflammatory reaction of adjacent lung tissue was seen.
  
  
  CONCLUSIONS
  This experimental study demonstrated the effectiveness of laser tissue welding applied to seal air leaks after lung surgery. Further studies are needed to verify acceptability for human application.
authors: Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy. marco.schiavon@unipd.it
authors: Marco
authors: M
authors: Schiavon
authors: Giuseppe
authors: G
authors: Marulli
authors: Andrea
authors: A
authors: Zuin
authors: Francesca
authors: F
authors: Lunardi
authors: Paolo
authors: P
authors: Villoresi
authors: Stefano
authors: S
authors: Bonora
authors: Fiorella
authors: F
authors: Calabrese
authors: Federico
authors: F
authors: Rea
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005355:Fibrosis; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054023:Lasers, Semiconductor; D008168:Lung / Q000473:pathology / Q000601:surgery*; D055370:Lung Injury / Q000473:pathology / Q000601:surgery*; D008422:Materials Testing; D011030:Pneumothorax / Q000473:pathology / Q000601:surgery*; D013552:Swine; D013908:Thoracotomy; D013997:Time Factors; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014945:Wound Healing
chemical_list: D014014:Tissue Adhesives
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