ICG dyed albumin and diode laser heating for soldering of the trachea

Laser tissue soldering is a technique for the closure of incisions, which provides an immediate air- and watertight bond. Previous studies have shown that this method can bond tracheal incisions with the aid of stay sutures or solid albumin strips. In this study we investigated whether soldering using a diode laser and indocyanine green (ICG) dyed liquid albumin solution as solder, was efficacious for the repair of tracheal incisions without the need for additional strengthening aids. A transverse incision was made in isolated pig tracheas. The incision was smeared with liquid solder composed of 42% bovine albumin and 0.1 mg/ml ICG, and soldered using a temperature-controlled fiberoptic diode laser system. The soldered tracheal ends were sealed and the burst pressure measured. In a series of experiments the burst pressure was found to be higher than 382 mm Hg. These preliminary results demonstrate that diode laser tissue soldering of tracheal incisions provides better results than with a CO2 laser, and that it is possible to achieve considerable soldering strength without the use of any additional strengthening procedures.