A Laser-Based Device for Tissue Fusion

Abstract

A prototype device (patent pending) has been created, and successfully used, to fuse tissue membranes as an alternative to sutures or staples. The joining, or coaptation, is accomplished through the controlled application of laser heating and pressure to induce protein denaturation and subsequent tissue fusion, through renaturation and intertwining, across the interface. Lasers have been used by a number of researchers to close wounds in controlled laboratory tests over the last 15 years. Many encouraging results have been obtained; however, no commercial delivery systems are currently available. This is due primarily to two factors: requiring an inordinate amount of experience on the part of the operator to detect changes in tissue appearance, and attempting to achieve general applicability for multiple tissue systems, i.e., a one-size-fits-all approach. Different combinations of system performance parameters may be required for different types of tissues. The present device overcomes these barriers as it is tailored for the particular application of septal laser fusion, namely for the coaptation of mucoperichondrial membranes. The optimal laser performance characteristics are pre-set for nasal tissue and packaged in an easy to use device. The important parameters involved in fusing biological tissues using radiation from laser sources are identified. The development of the device followed from computational modeling of the fusion process based on engineering first-principles from heat transfer, fluid dynamics and optics, and from experimental results on a particular tissue system. The experiments were designed and analyzed using orthogonal arrays, employing a subset of the relevant parameters, i.e., laser irradiance, dwell time and spot size, for a range of wavelengths. The in vitro fusion experiments employed 1 cm by 1 cm sections of equine nasal mucosa having a nominal thickness of 1 mm.