Schöni Daniel S, Bogni Serge, Bregy Amadé, Wirth Amina, Raabe Andreas, Vajtai Istvan, Pieles Uwe, Reinert Michael, Frenz Martin
Department of Neurosurgery, Inselspital Bern, University of Bern, Switzerland.
Lasers Surg Med. 2011 Dec;43(10):975-83. doi: 10.1002/lsm.21140. Epub 2011 Nov 22.
Laser tissue soldering (LTS) is a promising technique for tissue fusion but is limited by the lack of reproducibility particularly when the amount of indocyanine green (ICG) applied as energy absorber cannot be controlled during the soldering procedure. Nanotechnology enables the control over the quantitative binding of the ICG. The aim of this study was to establish a highly reproducible and strong tissue fusion using ICG packed nanoshells. By including the chromophore in the soldering scaffold, dilution of the energy absorber during the soldering procedure is prevented. The feasibility of this novel nanoshell soldering technique was studied by assessing the local heating of the area and tensile strength of the resulting fused tissue.
STUDY DESIGN/MATERIALS AND METHODS: Nanoshells with a diameter of 250-270 nm were loaded with ICG and included in a porous polycaprolactone (PCL) scaffold doped with albumin solder. The nanoshell scaffold was used in a flexible, semi-dry formulation suitable for surgical use. Heat development, tensile strength as well as tissue damage were assessed.
Rabbit aortic arteries were successfully soldered using an ICG packed nanoshell scaffold. Tensile strengths of these nanoshell soldered anastomoses were found to be 734 ± 327 mN (median = 640 mN). Thermal damage was restricted to the adventitia at the irradiated area. In addition, absorber dilution was prevented during the soldering procedure resulting in significantly lower variance in maximum temperature (P = 0.03) compared to the classical liquid ICG soldering technique.
Using nanoshells, controlled amounts of chromophore could successfully be bound into the polymer scaffold. Diode laser soldering of vascular tissue using ICG-nanoshell scaffolds leads to strong and reproducible tissue fusion. With optimally chosen settings of irradiation time, nanoshells coating and scaffold properties, our improved LTS procedure demonstrates the potential for a clinically applicable anastomosis technique.
激光组织焊接（LTS）是一种很有前景的组织融合技术，但由于缺乏可重复性而受到限制，特别是在焊接过程中作为能量吸收剂的吲哚菁绿（ICG）用量无法控制时。纳米技术能够控制ICG的定量结合。本研究的目的是使用负载ICG的纳米壳建立高度可重复且牢固的组织融合。通过将发色团包含在焊接支架中，可防止焊接过程中能量吸收剂的稀释。通过评估融合组织区域的局部加热情况和拉伸强度，研究了这种新型纳米壳焊接技术的可行性。
研究设计/材料与方法：将直径为250 - 270nm的纳米壳负载ICG，并包含在掺杂白蛋白焊料的多孔聚己内酯（PCL）支架中。纳米壳支架采用适合手术使用的柔性半干制剂形式。评估了热生成、拉伸强度以及组织损伤情况。
使用负载ICG的纳米壳支架成功焊接了兔主动脉。这些纳米壳焊接吻合口的拉伸强度为734±327mN（中位数 = 640mN）。热损伤局限于照射区域的外膜。此外，与传统液体ICG焊接技术相比，焊接过程中防止了吸收剂稀释，导致最高温度差异显著降低（P = 0.03）。
使用纳米壳能够将可控量的发色团成功结合到聚合物支架中。使用ICG - 纳米壳支架对血管组织进行二极管激光焊接可实现牢固且可重复的组织融合。通过优化选择照射时间、纳米壳涂层和支架特性的设置，我们改进的LTS程序展示了一种临床适用的吻合技术的潜力。
