Sutureless liver repair and hemorrhage control using laser-mediated fusion of human albumin as a solder

Yasmin Wadia, Hua Xie, Michio Kajitani

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: Major liver trauma has a high mortality because of immediate exsanguination and a delayed morbidity from septicemia, peritonitis, biliary fistulae, and delayed secondary hemorrhage. We evaluated laser soldering using liquid albumin for welding liver injuries. Methods: Fourteen lacerations (6 × 2 cm) and 13 nonanatomic resection injuries (raw surface, 8 × 2 cm) were repaired. An 805-nm laser was used to weld 53% liquid albumin-indocyanine green solder to the liver surface, reinforcing it by welding a free autologous omental scaffold. The animals were heparinized and hepatic inflow occlusion was used for vascular control. For both laceration and resection injuries, 16 soldering repairs were evaluated acutely at 3 hours. Eleven animals were evaluated chronically, two at 2 weeks and nine at 4 weeks. Results: All 27 laser mediated-liver repairs had minimal blood loss compared with the suture controls. No dehiscence, hemorrhage, or bile leakage was seen in any of the laser repairs after 3 hours. All 11 chronic repairs healed without complication. Conclusion: This modality effectively seals the liver surface, joins lacerations with minimal thermal injury, and works independently of the patient's coagulation status.

Original languageEnglish (US)
Pages (from-to)51-59
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume51
Issue number1
DOIs
StatePublished - Jul 2001

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Keywords

  • Albumin solder
  • Indocyanine green
  • Liver trauma
  • Tissue welding

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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