AN OPTIMAL LASER SOURCE FOR SMALL-DIAMETER VASCULAR ANASTOMOSES

THIS RESEARCH WILL DEMONSTRATE THAT A NEW 1.9-MU M LASER CAN PERFORM LASER-ASSISTED VASCULAR ANASTOMOSES OF SMALL-DIAMETER VESSELS (1 TO 5 MM). THE 1.9-MU M LIGHT HAS OPTIMAL ABSORPTION CHARACTERISTICS TO ENSURE AN EVEN DEPOSITION OF ENERGY IN THE VESSEL WALL. THIS SHOULD RESULTIN A MORE DESIRED TEMPERATURE PROFILE IN THE REGION OF THE ANASTOMOSIS WHEN COMPARED WITH ALTERNATIVE SOURCES. THE PROPOSED LASER HAS SEVERAL ADVANTAGES OVER THE MORE COMMONLY USED CO2 AND AR LASERS. UNLIKE THE CO2 LASER, 1.9-MU M OUTPUT IS TRANSMITTABLE THROUGH SILICA FIBEROPTICS,THUS FACILITATING OPERATIVE CONVENIENCE AND CONTROL IN THE STERILE FIELD. COMPARED TO THE AR LASER, THE 1.9-MU M LASER REQUIRES LOWER POWER FOR WELDING AND NO IRRIGATION TO PREVENT TISSUE DAMAGE. SUCH A SOURCE FOR WELDING SMALL-DIAMETER VESSELS HAS SEVERAL ADVANTAGES OVER MANUAL SUTURING. PHASE I STUDIES WILL CONCENTRATE ON QUANTITATING THE INFLUENCE OF ENERGY DEPOSITION USING THE 1.9-MU M LASER IN VIVO FOR BOTH ACUTE AND CHRONIC VASCULAR WELDS VIA MEASUREMENTS OF THE TENSILE STRENGTH OF THE LASER ANASTOMOSES OF VARIOUS VESSEL DIAMETERS. THIS WILL BE ACCOMPLISHED BY MEASURING THE BURST PRESSURE OF THE LASED ANASTOMOSES AND NORMALIZING TO THAT OF RESORBABLE SUTURED ANASTOMOSIS. A LOW-POWER, COMPACT 1.9-MU M LASER WILL BE DESIGNED, FABRICATED, AND TESTED IN VIVO IN PHASE II SPECIFICALLY FOR CLINICAL WELDING APPLICATIONS.