Nanoshell assisted laser soldering of vascular tissue

Background and Objectives 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 enabl...

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Published in:	Lasers in surgery and medicine Vol. 43; no. 10; pp. 975 - 983
Main Authors:	Schöni, Daniel S., Bogni, Serge, Bregy, Amadé, Wirth, Amina, Raabe, Andreas, Vajtai, Istvan, Pieles, Uwe, Reinert, Michael, Frenz, Martin
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-12-2011
Subjects:	albumin Anastomosis, Surgical - methods Animals Aorta - surgery biodegradable polymer end-to-end anastomoses Feasibility Studies ICG Indocyanine Green Laser Therapy - methods Lasers, Semiconductor - therapeutic use Nanoshells - chemistry nanotechnology Polyamines Rabbits Reproducibility of Results Silicon Dioxide Temperature Tensile Strength Tissue Adhesives Tissue Scaffolds - chemistry tissue soldering Wound Closure Techniques
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Summary:	Background and Objectives 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. Results 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. Conclusion 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. Lasers Surg. Med. 43:975–983, 2011. © 2011 Wiley Periodicals, Inc.
Bibliography:	ark:/67375/WNG-LL0K43F7-3 ArticleID:LSM21140 Conflict of interest: The authors have no conflicts of interest regarding any information presented in this paper. istex:BF74D20535F746685B5028B8D274EBC83E83E710 Swiss Commission of the Encouragement of Scientific Research - No. 11478.1pfls-ls ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0196-8092 1096-9101
DOI:	10.1002/lsm.21140