title: Infrared laser sealing of porcine vascular tissues using a 1,470 nm diode laser: Preliminary in vivo studies.
abstract: Infrared (IR) lasers are being explored as an alternative to radiofrequency (RF) and ultrasonic (US) devices for rapid hemostasis with minimal collateral zones of thermal damage and tissue necrosis. Previously, a 1,470 nm IR laser sealed and cut ex vivo porcine renal arteries of 1-8 mm diameter in 2 seconds, yielding burst pressures greater than 1,200 mmHg and thermal coagulation zones less than 3 mm. This preliminary study describes in vivo testing of a handheld laser probe in a porcine model.
  
  
  
  A handheld prototype with vessel/tissue clasping mechanism was tested on 73 blood vessels less than 6 mm diameter using 1,470 nm laser power of 35 W for 1-5 seconds. Device power settings, irradiation time, tissue type, vessel diameter, and histology sample number were recorded for each procedure. The probe was evaluated for hemostasis after sealing isolated and bundled arteriole/venous (A/V) vasculature of porcine abdomen and hind leg. Sealed vessel samples were collected for histological analysis of lateral thermal damage.
  
  
  
  Hemostasis was achieved in 57 of 73 seals (78%). The probe consistently sealed vasculature in small bowel mesentery, mesometrium, and gastrosplenic and epiploic regions. Seal performance was less consistent on hind leg vasculature including saphenous arteries/bundles and femoral and iliac arteries. Collagen denaturation averaged 1.6 ± 0.9 mm in eight samples excised for histologic examination.
  
  
  
  A handheld laser probe sealed porcine vessels, in vivo. Further probe development and laser parameter optimization is necessary before infrared lasers may be evaluated as an alternative to RF and US vessel sealing devices. Lasers Surg. Med. 49:366-371, 2017. © 2016 Wiley Periodicals, Inc.
authors: Department of Physics and Optical Science, University of North Carolina at Charlotte, Charlotte, North Carolina.
authors: Christopher M
authors: CM
authors: Cilip
authors: Covidien, Boulder, Colorado.
authors: Duane
authors: D
authors: Kerr
authors: Covidien, Boulder, Colorado.
authors: Cassandra A
authors: CA
authors: Latimer
authors: Department of Physics and Optical Science, University of North Carolina at Charlotte, Charlotte, North Carolina.
authors: Sarah B
authors: SB
authors: Rosenbury
authors: Department of Physics and Optical Science, University of North Carolina at Charlotte, Charlotte, North Carolina.
authors: Nicholas C
authors: NC
authors: Giglio
authors: Department of Physics and Optical Science, University of North Carolina at Charlotte, Charlotte, North Carolina.
authors: Thomas C
authors: TC
authors: Hutchens
authors: Covidien, Boulder, Colorado.
authors: William H
authors: WH
authors: Nau
authors: Department of Physics and Optical Science, University of North Carolina at Charlotte, Charlotte, North Carolina.
authors: Nathaniel M
authors: NM
authors: Fried
mesh_terms: D000818:Animals; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D053685:Laser Therapy / Q000295:instrumentation*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D013552:Swine; D014656:Vascular Surgical Procedures / Q000295:instrumentation*
keywords: arteries; blood vessels; coagulation; hemostasis; infrared; laser; sealing