2000 Abstract: 2323: Neutral Red-Doped Albumin as a New Sealant for Intestinal Laser Soldering.
Abstracts
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Denatured albumin has been used as a protein solder for post-operative tissue repair. Laser soldering is appealing in high-risk patients undergoing intestinal re-anastomosis and pancreato-jejunostomies, but infrared lasers can cause thermal injury to the viscera. We evaluated neutral red doped albumin and visible KTP532 laser light as an improved method for denaturing albumin in situ. The objective was to evaluate neutral red and reduced laser energy to form an effective albumin seal after intestinal reanastomosis. Methods: Brown Norwegian rats underwent intestinal transection and reanastomosis with 4 sutures placed circumferentially around the anastomosis. Each rat underwent intestinal soldering using either 40% albumin, 50% albumin, 60% albumin gel, or 30% collagen all doped with 1 mg/ml of neutral red (N=6). Each anastomosis received two layers of protein solder using KTP532 laser illumination at 1W via bare fiberoptics. Results: Rats receiving collagen, 40% albumin, and 50% albumin solders were found to have anastomotic leaks during the post-operative period. Rats receiving dessicated gel of 60% albumin/neutral red solder had no anastomotic leaks. No injury to the bowels were seen from the laser light. Operative temperature of the tissue was 42 degrees Celsius. Conclusion: Visible laser light used to induce tissue bonding with albumin- neutral red solder is feasible and creates a water-tight seal. This is the first report of protein solder doped with neutral red using light to safely solder intestinal anastomosis. This agent may prove to be valuable in highrisk patients undergoing gastrointestinal reconstruction. |
