Kirsch A J, Chang D T, Kayton M L, Libutti S K, Treat M R, Hensle T W
Department of Urology, Columbia University, College of Physicians & Surgeons, New York City 10032, USA.
Lasers Surg Med. 1996;18(3):225-30. doi: 10.1002/(SICI)1096-9101(1996)18:3<225::AID-LSM2>3.0.CO;2-U.
Fistula and stricture formation at the site of sutured anastomoses are frequent complications of major urethroplasty. We performed urethroplasty using laser-welded skin tube grafts in the hope that in addition to being free of suture holes, grafts would be as strong as or stronger than sutured controls.
STUDY DESIGN/MATERIAL AND METHODS: Scrotal skin was harvested from each of 11 rabbits and fashioned into tubes 3-4 cm in length using either conventional suture techniques or laser welding. Welding was performed using an 808-nm diode laser and a dye-enhanced solder composed of albumin and sodium hyaluronate. Laser power density was 15.9 watts/cm2. For each graft, leak pressure, and urethroplasty time (tube creation and anastomosis to native urethra) were measured.
Urethroplasty time was significantly shorter and initial leak pressures were seven times greater in the laser-welded group.
The near-uniform occurrence of strictures in both groups suggests that the rabbit is not an ideal model for free tube graft urethroplasty. However, our data indicate that laser welding with albumin-based solder, when used in the appropriate setting, may offer the potential for the rapid creation of watertight grafts in reconstructive urology.
