Tissue fusion, a new opportunity for sutureless bypass surgery

Bogni, Serge; Schöni, Daniel; Constantinescu, Mihai Adrian; Wirth, Amina; Vajtai, Istvan; Bregy, Amadé; Raabe, Andreas; Pieles, Uwe; Frenz, Martin; Reinert, Michael (2011). Tissue fusion, a new opportunity for sutureless bypass surgery. Acta neurochirurgica - supplementa, 112, pp. 45-53. Wien: Springer 10.1007/978-3-7091-0661-7_9

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Microsurgical suturing is the standard for cerebral bypass surgery, a technique where temporary occlusion is usually necessary. Non-occlusive techniques such as excimer laser-assisted non-occlusive anastomosis (ELANA) have certainly widened the spectrum of treatment of complex cerebrovascular situations, such as giant cerebral aneurysms, that were otherwise non-treatable. Nevertheless, the reduction of surgical risks while widening the spectrum of indications, such as a prophylactic cerebral bypass, is still a main aim, that we would like to pursue with our sutureless tissue fusion research. The primary concern in sutureless tissue fusion- and especially in tissue fusion of cerebral vessels- is the lack of reproducibility, often caused by variations in the thermal damage of the vessel. This has prevented this novel fusion technique from being applicable in daily surgical use. In this overview, we present three ways to further improve the laser tissue soldering technique.In the first section entitled "Laser Tissue Soldering Using a Biodegradable Polymer," a porous polymer scaffold doped with albumin (BSA) and indocyanine green (ICG) is presented, leading to strong and reproducible tensile strengths in tissue soldering. Histologies and future developments are discussed.In the section "Numerical Simulation for Improvement of Laser Tissue Soldering," a powerful theoretical simulation model is used to calculate temperature distribution during soldering. The goal of this research is to have a tool in hand that allows us to determine laser irradiation parameters that guarantee strong vessel fusion without thermally damaging the inner structures such as the intima and endothelium.In a third section, "Nanoparticles in Laser Tissue Soldering," we demonstrate that nanoparticles can be used to produce a stable and well-defined spatial absorption profile in the scaffold, which is an important step towards increasing the reproducibility. The risks of implanting nanoparticles into a biodegradable scaffold are discussed.Step by step, these developments in sutureless tissue fusion have improved the tensile strength and the reproducibility, and are constantly evolving towards a clinically applicable anastomosis technique.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery
08 Faculty of Science > Institute of Applied Physics
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Bogni, Serge; Constantinescu, Mihai Adrian; Vajtai, Istvan; Raabe, Andreas; Frenz, Martin and Reinert, Michael

Subjects:

600 Technology > 620 Engineering

ISSN:

0065-1419

Publisher:

Springer

Language:

English

Submitter:

Jörg Arnoldi

Date Deposited:

04 Oct 2013 14:18

Last Modified:

17 Dec 2014 11:34

Publisher DOI:

10.1007/978-3-7091-0661-7_9

PubMed ID:

21691987

Web of Science ID:

000304028500009

URI:

https://boris.unibe.ch/id/eprint/5577 (FactScience: 210343)

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