Laser tissue soldering: applications in the genitourinary system

Photothermal-driven micro/nanomotors: From structural design to potential applications

Micro/nanomotors (MNMs) that accomplish autonomous movement by transforming external energy into mechanical work are attractive cargo delivery vehicles. Among various propulsion mechanisms of MNMs, photothermal propulsion has gained considerable attention because of their unique advantages, such as remote, flexible, accurate, biocompatible, short response time, etc. Moreover, besides as a propulsion source, the light has been extensively investigated as an excitation source in bioimaging, photothermal therapy (PTT), photodynamic therapy (PDT) and so on. Furthermore, the geometric topology and morphology of MNMs have a tremendous impact on improving their performance in motion behavior under NIR light propulsion, environmental suitability and functional versatility. Hence, this review article provides a comprehensive overview of structural design principles and construction strategies of photothermal-driven MNMs, and their emerging nanobiomedical applications. Finally, we further provide an outlook towards prospects and challenges during the development of photothermal-driven MNMs in the future. STATEMENT OF SIGNIFICANCE: Photothermal-driven micro/nanomotors (MNMs) that are regarded as functional cargo delivery tools have gained considerable attention because of unique advantages in propulsion mechanisms, such as remote, flexible, accurate and fully biocompatible light manipulation and extremely short light response time. The geometric topology and morphology of MNMs have a tremendous impact on improving their performance in motion behavior under NIR light propulsion, environmental suitability and functional versatility of MNMs. There are no reports about the review focusing on photothermal-driven MNMs up to now. Herein, we systematically review the latest progress of photothermal-driven MNMs including design principle, fabrication strategy of various MNMs with different structures and nanobiomedical applications. Moreover, the summary and outlook on the development prospects and challenges of photothermal-driven MNMs are proposed, hoping to provide new ideas for the future design of photothermal-driven MNMs with efficient propulsion, multiple functions and high biocompatibility.

Albumin solder covalently bound to a polymer membrane: New approach to improve binding strength in laser tissue soldering in-vitro

Laser tissue soldering (LTS) based on indocyanine green (ICG)-mediated heat-denaturation of proteins might be a promising alternative technique for micro-suturing, but up to now the problem of too weak shear strength of the solder welds in comparison to sutures is not solved. Earlier reports gave promising results showing that solder supported by carrier materials can enhance the cohesive strength of the liquid solder. In these studies, the solder was applied to the carriers by dip coating. Higher reliability of the connection between the solder and the carrier material is expected when the solder is bound covalently to the carrier material. In the present study a poly(ether imide) (PEI) membrane served as carrier material and ICG-supplemented albumin as solder substrate. The latter was covalently coupled to the carrier membrane under physiological conditions to prevent structural protein changes. As laser source a diode continuous-wave laser emitting at 808 nm with intensities between 250 mW and 1500 mW was utilized. The albumin functionalized carrier membrane was placed onto the tunica media of explanted pig thoracic aortae forming an overlapping area of approximately 0.5×0.5 cm2. All tests were performed in a dry state to prevent laser light absorption by water. Infrared spectroscopy, spectro-photometrical determination of the secondary and primary amine groups after acid orange II staining, contact angle measurements, and atomic force microscopy proved the successful functionalization of the PEI membrane with albumin. A laser power of 450 mW LTS could generate a membrane-blood vessel connection which was characterized by a shear strength of 0.08±0.002 MPa, corresponding to 15% of the tensile strength of the native blood vessel. Theoretically, an overlapping zone of 4.1 mm around the entire circumference of the blood vessel could have provided shear strength of the PEI membrane-blood vessel compound identical to the tensile strength of the native blood vessel. These in-vitro results confirmed the beneficial effects of solder reinforcement by carrier membranes, and suggest LTS with covalently bound solders on PEI substrates for further studies in animal models.

Guidable Thermophoretic Janus Micromotors Containing Gold Nanocolorifiers for Infrared Laser Assisted Tissue Welding

Current wound sealing systems such as nanoparticle-based gluing of tissues allow almost immediate wound sealing. The assistance of a laser beam allows the wound sealing with higher controllability due to the collagen fiber melting which is defined by loss of tertiary protein structure and restoration upon cooling. Usually one employs dyes to paint onto the wound, if water absorption bands are absent. In case of strong bleeding or internal wounds such applications are not feasible due to low welding depth in case of water absorption bands, dyes washing off, or the dyes becoming diluted within the wound. One possible solution of these drawbacks is to use autonomously movable particles composing of biocompatible gold and magnetite nanoparticles and biocompatible polyelectrolyte complexes. In this paper a proof of principle study is presented on the utilization of thermophoretic Janus particles and capsules employed as dyes for infrared laser-assisted tissue welding. This approach proves to be efficient in sealing the wound on the mouse in vivo. The temperature measurement of single particle level proves successful photothermal heating, while the mechanical characterizations of welded liver, skin, and meat confirm mechanical restoration of the welded biological samples.

A multi-wavelength fiber-optic temperature-controlled laser soldering system for upper aerodigestive tract reconstruction: an animal model

OBJECTIVE

Laser soldering of a thick multilayer organ using conventional CO(2) lasers is ineffective. The purpose of this work was to develop a method for bonding the multilayer tissue of the upper aerodigestive tracts (UADT) without the need of sutures or stapling.

STUDY DESIGN

Animal model.

SETTING

Academic research laboratory.

SUBJECTS AND METHODS

The authors developed a multi-wavelength laser system, based on 2 fiber-optic lasers applied simultaneously. A highly absorbable CO(2) laser interacts with the muscular layer, and a nonabsorbable GaAs laser interacts with indocyanine-green solid albumin, placed between the mucosa and the muscular layer. The authors used an ex vivo porcine model to examine the capability of this system to effectively correct esophageal tears.

RESULTS

The soldered esophagi burst pressure was >175 cm H(2)O (98% success rate) in 88 of the 90 experiments. A conventional CO(2) laser soldering resulted in insufficient bonding (mean burst pressure of 40 ± 7 cm H(2)O, n = 5), while the multi-wavelength laser system provided an ~9-fold tighter seal (359 ± 75.4 cm H(2)O, P < .0001, n = 15). Burst pressures after conventional suturing of the defect was significantly lower (106 ± 65.8 cm H(2)O, P < .001) than in the multi-wavelength laser system.

CONCLUSIONS

Bonding of the UADT mucosa using a multi-wavelength, temperature-controlled laser soldering system can support significantly higher pressures then conventional CO(2) laser soldering and suture repair. The mean bonding pressure was 3.5-fold higher than the maximal swallowing pressure. Our findings provide a basis for implementation of new surgical tools for repair of esophageal perforations.

Suture-free laser-assisted vessel repair using CO2 laser and liquid albumin solder

Numerous studies have shown that the use of proteinic solders during laser-assisted vascular anastomosis (LAVA) and repair (LAVR) can significantly increase welding strength, but these studies combined solder-mediated LAVA/R with the use of stay sutures, thereby defeating its purpose. In an in vitro study, we examined the leaking point pressures (LPPs) and histological damage profile of porcine carotid arteries following albumin solder-mediated CO(2) LAVR without the use of sutures. Longitudinal arteriotomies (9.1+/-0.8 mm in length) were sheathed with 25% liquid bovine serum albumin solder, and LAVR was performed using a micromanipulator-controlled CO(2) laser operating at 170-mW power and 1.25-mm spot size in continuous wave mode. The welding regime consisted of a transversal zigzag pass followed by one or two longitudinal zigzag passes, producing an irradiance of 13.9 W/cm(2) and energies of 10.5 J and 11.3 J per mm weld, respectively. LPPs were measured by the fluid infusion technique, and histological analysis was performed with light, fluorescence, and polarization microscopy. The LPP of the two-pass welds was 351+/-158 mmHg versus 538+/-155 mmHg for the three-pass welds. Thermal damage was confined primarily to the adventitial layers, with limited heat diffusion into the media below the solder around the coaptation interface.