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7 February 2017 The mechanism of tissue welding using a green laser: revisited
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A “green” laser (e.g. Nd:YAG, λ = 532 nm) together with the red dye Rose Bengal (RB) have been used for photochemical tissue bonding (PTB). It has been reported that irradiation of RB with light at 532 nm produces free radicals. For tissue bonding with a Nd:YAG laser it has been proposed that the free radicals than crosslink the tissue collagen and lead to the closing of the surgical incisions. RB is also a red solution and it is possible that RB absorbs the photons delivered from the laser and converts them into heat with a measurable local temperature increase. It is possible that the mechanism for PTB is not only caused by free radical formation but also by a temperature increase in the tissue. In the present study we measured the local tissue temperature with a micro thermometer during irradiation with a Nd:YAG laser before and after RB was applied. For the present laser settings “tissue painting” with RB lead to a temperature increase resulting in tissue coagulation and charring. PTB was also studied for RB with a free radical scavenger, vitamin C. No significant difference in bonding strength was found for RB alone and for RB together with a free radical scavenger. In case no RB was applied no tissue bonding occurred. Bonding strength was quantified using the leakage seal test
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C.-P. Richter, R. Bellam, E. Hezarkhani, and T. Fiebig "The mechanism of tissue welding using a green laser: revisited", Proc. SPIE 10039, Optical Imaging, Therapeutics, and Advanced Technology in Head and Neck Surgery and Otolaryngology, 100390N (7 February 2017);

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