1950-nm diode laser-assisted microanastomoses (LAMA): an innovative surgical tool for hand surgery emergencies

Lasers Med Sci. 2015 May;30(4):1269-73. doi: 10.1007/s10103-015-1711-z. Epub 2015 Feb 21.

Abstract

Based on previous observations, the 1950-nm diode laser seems to be an ideal wavelength for laser microvascular anastomoses. The data presented here, part of a larger ongoing study, assess its use in emergency hand surgery. Between 2011 and 2014, 11 patients were operated on for hand trauma with laser-assisted microanastomoses (LAMA) and prospectively analysed. LAMA was performed with a 1950-nm diode laser after placement of equidistant stitches. For vessel size <1.5 mm, the following laser parameters were used: spot size 400 μm, five spots for each wall, power 125 mW, and arterial/venous fluence 100/90 J/cm(2) (spot duration 1/0.9 s). Mean operating time for arterial and venous microanastomoses was 7.3 ± 1.4 and 8.7 ± 1.0 min, respectively. Three anastomoses required a secondary laser application. Arterial and venous patency rates were 100 % at the time of surgery. The success rate for the 11 procedures assessed clinically and with the Doppler was 100 %. The technique is compared to the current literature. The 1950-nm LAMA is a reliable tool with excellent results in emergency hand surgery. The system is very compact and transportable for utilization in the emergency operating room.

MeSH terms

  • Adult
  • Anastomosis, Surgical / methods
  • Emergency Treatment
  • Hand / blood supply*
  • Hand / surgery
  • Humans
  • Laser Therapy*
  • Lasers, Semiconductor / therapeutic use*
  • Male
  • Microsurgery / methods
  • Microvessels / surgery*
  • Middle Aged
  • Prospective Studies
  • Vascular Patency
  • Vascular Surgical Procedures / methods
  • Young Adult