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 The futuristic technique is better than current methods which
damage tissue and can cause scarring, researchers from Tel Aviv
University believe.
Head of the Applied Physics Department Abraham Katzir was behind the
research. He says traditional stitches or more modern glues are
inferior to his new method.
"Today most of the incisions that are made by surgeons are bonded
using sutures or clips or chemical glues and there are problems with
these methods. And we found that if you heat the incisions spot by
spot by laser you can bond it without incisions and hopefully with
very little or no scarring," he said.
Sutures have been used for thousands of years, but the researchers'
handheld bonding device could replace them once the technique is
refined enough to be used in human patients.
"The advantages of the procedure are that we can get bonding to be
probably much stronger than with sutures. We hope that the scarring
will also be less than with sutures and eventually we get the safety
of the procedure to be better," said Ichilov Medical Center
ophthalmic surgeon, David Versano.
An attempt to 'weld' tissue through heating was tried in the 1970s
and 80s, but prior to the Tel Aviv University team's experiments,
nobody had been able to accurately control the heat created by laser
light, Katzir said.
"If you heat a spot on an incision to temperatures lower than say 50
or 55 degrees centigrade nothing happens. If you are above 65
degrees than you cause scaring and therefore we found that you have
to heat each spot on an incision to roughly 60 degrees centigrade
and then you get good bonding without scaring. And we carried out
experiments on a large number of tissues, on skin, on cornea,"
Katzir said.
Katzir and his team made their discovery after developing an
innovative optical fiber that can transmit infra-red light and
simultaneously measure the heat of the tissue. Only the single fiber
method affords the device the ability to accurately control the
laser's power, he said.
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"What we developed is a special optical fiber that can both transmit
the laser energy to a spot on an incision and carefully measure the
temperature of that spot, so then we can monitor and control the
temperature of that spot and this is something that others have not
done yet," he said.
Tissue bonding occurs with the aid of collagen, a protein whose
structure resembles microscopic hooks on each edge of a cut which
can link together when heated. The bond becomes firm when the tissue
cools, Katzir said.
He predicted that a practical tool, once developed, would have
dramatic implications in medicine.
The laboratory device has been tested on healing corneal incisions
in eyes taken from dead cows and a permanent, tight seal was
achieved instantly with minimal thermal damage to the tissue, the
research paper said.
The single optical fiber is narrow enough to be threaded into a very
thin tube which would allow the device to be used in endoscopic
surgery for microscopic repairs to internal blood vessels and
nerves, Katzir said. In the first tests on 10 human patients,
undertaken in recent months, wounds treated with the laser technique
successfully healed, with a reduction in scar tissue. According to
Katzir, follow-up examination one year after the surgery should show
whether the technique leaves less scarring than traditional
stitching.
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