Liver repair and hemorrhage control by using laser soldering of liquid albumin in a porcine model

Background and Objective: Ne evaluated laser soldering by using liquid albu min for welding liver injuries. Major liver trauma has a high mortality bec ause of immediate exsanguination and a delayed morbidity from septicemia, p eritonitis, biliary fistulae, and delayed secondary hemorrhage. Study Design/Materials and Methods: Eight laceration (6 x 2 cm) and eight n onanatomic resection injuries (raw surface, 6 x 2 cm) were repaired. An 805 -nm laser was used to weld 50% liquid albumin-indocyanine green solder to t he liver surface, reinforcing it with a free autologous omental scaffold. T he animals were heparinized and hepatic inflow occlusion was used for vascu lar control. All 16 soldering repairs were evaluated at 3 hours. Results: All 16 laser mediated liver repairs had minimal blood loss as comp ared with the suture controls. No dehiscence, hemorrhage, or bile leakage w as seen in any of the laser repairs after 3 hours. Conclusion: Laser fusion repair of the liver is a reliable technique to gai n hemostasis on the raw surface as well as weld lacerations. (C) 2000 Wiley -Liss, Inc.