The objective of ther research in this proposal is to develop instrumentation and techniques to facilitate tissue approximation and repair in minimally invasive surgical (MIS) procedures where current methods of wound closure are either extremely difficult, such as suturing, or contraindicated, such as staples in vascular or urological reconstructions, The primary emphasis is on developing a laparoscopic device, which can be used to complete laser assisted repairs (tissue welding) or urologic structures. An enterocystoplasty is chosen because in its current suture intensive form, a conversion to a MIS procedure is unlikely. A programmatic approach has been chosen for this research program. Three major factors influencing tissue welded repairs 1) tissue absorption, 2) the temperature achieved during welding, 3) the use of tissue solders, were evaluated for acute repairs in Phase I. the Phase II studies will initially evaluate the chronic healing of laser assisted repairs. A laparoscopic instrument will also be constructed in Phase II to convert the enterocystoplasty to a MIS procedure. the instrumentation and methods developed ere should also have broad applicability to other urological reconstructions.
The laparoscopic instrument will be directly applicable to urologic reconstructions currently being completed via open procedures. These include enterocystoplasty, gastrocystoplasty, pyeloplasty, and reimplantation of the ureters. there are approximately 20,000 of these cases completed annually by the 6,500 practicing urologists in the US. In addition, other surgical procedures requiring minimally invasive tissue reconstruction and repair may also be candidates for this repair technology.
| Bleustein, C B; Cuomo, B; Mingin, G C et al. (2000) Laser-assisted demucosalized gastrocystoplasty with autoaugmentation in a canine model. Urology 55:437-42 |
