LASER PATCH WELDING - EXPERIMENTAL-STUDY FOR APPLICATION TO ENDOSCOPIC CLOSURE OF BRONCHOPLEURAL FISTULA, A PRELIMINARY-REPORT

Background and Objective: Postoperative bronchopleural fistula is a serious complication following pulmonary resection. To close the bronchopleural fistula, we developed a new method of endoscopic patch welding using laser tissue welding between bronchial tissue and a patch. Study Design/Materials and Methods: The feasibility of the laser patch welding was examined by in vitro and in vivo animal experiments. A newly developed carbon monoxide (CO) laser and an Argon ion laser were evaluated. Various tissue membranes and artificial membranes were evaluated as patch materials. Results: We found that the combination of expanded polytetrafluoroethylene (e-PTFE; 200 mum in thickness) and the CO laser with contact irradiation method offered the strongest laser patch welding. Using this combination, the irradiation at 400 W/cm2 for 10 seconds resulted in 16-18 g of measured traction strength at the welding spot (2 mm in diameter). The welded e-PTFE patch at bronchial stump remained for 5 weeks. Conclusion: Our results encourage use of this novel laser patch technique for clinical applications. (C) 1995 Wiley-Liss, Inc.