Conference proceeding
Hypospadias repair using laser tissue soldering (LTS): preliminary results of a prospective randomized study
Proceedings of SPIE, Vol.3245(1), pp.309-312
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII
07/01/1998
DOI: 10.1117/12.312328
Abstract
Purpose: The purpose of this study was to evaluate laser tissue soldering using an 808 nm diode laser and wavelength- matched human albumin solder for urethral surgery in children. Methods: Currently, 30 boys, ages 3 months to 8 years were randomized to standard suturing (n equals 22) or 'sutureless' laser hypospadias repair (n equals 18). Laser soldering was performed with a human albumin solder doped with indocyanine green dye (2.5 mg/ml) using a laser power output of 0.5 W, pulse duration of 0.5 sec, and interval of 0.1 sec. Power density was approximately 16 W/cm
. In the laser group, sutures were used for tissue alignment only. At the time of surgery, neourethral and penile lengths, operative time for urethral repair, and number of sutures/throws were measured. Postoperatively, patients were examined for complications of wound healing, stricture, or fistula formation. Results: Mean age, severity of urethral defect, type of repair, and neourethra length were equivalent between the two groups. Operative time was significantly faster for laser soldering in both simple (1.6 plus or minus 0.21 min, p less than 0.001) and complex (5.4 plus or minus 0.28 min, p less than 0.0001) hypospadias repairs compared to controls (10.6 plus or minus 1.4 min and 27.8 plus or minus 2.9 min, respectively). The mean number of sutures used in the laser group for simple and complex repairs (3.3 plus or minus 0.3 and 8.1 plus or minus 0.64, respectively) were significantly (p less than 0.0001) less than for controls (8.2 plus or minus 0.84 and 20 plus or minus 2.3, respectively). Followup was between 3 months and 14 months. The overall complication rate in the laser group (11%) was lower than the controls (23%). However, statistical significance (p less than 0.05) was achieved only for the subgroup of patients undergoing simple repairs (LTS, 100% success versus suturing, 69% success). Conclusions: These preliminary results indicate that laser tissue soldering for hypospadias repair may be performed in a nearly sutureless fashion and in a more rapid manner than for conventional suturing. The trend towards a decreased rate of complications in the laser group at this time indicates that laser soldering may be an improved method of tissue closure for hypospadias repair. We continue to accrue patients to this study.
Details
- Title: Subtitle
- Hypospadias repair using laser tissue soldering (LTS): preliminary results of a prospective randomized study
- Creators
- Andrew J Kirsch - Children's Hospital of PhiladelphiaChristopher S Cooper - Children's Hospital of PhiladelphiaDouglas A Canning - Children's Hospital of PhiladelphiaHoward M Snyder III - Children's Hospital of PhiladelphiaStephen A Zderic - Children's Hospital of Philadelphia
- Resource Type
- Conference proceeding
- Publication Details
- Proceedings of SPIE, Vol.3245(1), pp.309-312
- Conference
- Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII
- DOI
- 10.1117/12.312328
- ISSN
- 0277-786X
- Language
- English
- Date published
- 07/01/1998
- Academic Unit
- Urology; Medicine Administration; Stead Family Department of Pediatrics
- Record Identifier
- 9984320062102771
Metrics
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