Laser vascular welding

Tissue fusion using laser welding has been evaluated in several applications; cosmetic closure of skin incisions, sutureless repair of enterotomies, anastomoses of the trachea, vas deferens and Fallopian tubes. Laser vascular tissue welding is an evolving, promising new technology with many advantages; healing without foreign body reaction, decreased incidence of intimal hyperplasia and unrestricted enlargement of growing vessels. Laser vascular tissue welding has been investigated in small and medium sized vessels in experimental and few clinical studies. Trials to improve the result of laser vascular welding led to important technical refinements. Proper selection of the suitable laser wave-length, the use of pulsed laser, the use of solders and photo enhancers, automated control of laser dosimetry and closed loop feed-back control are new innovations. This work aimed at reviewing the literature of laser vascular tissue welding. Laser welding trials were conducted on 10 rabbits aorta and 5 goats femoral arteries using argon laser with favourable mechanical and histological results

Prognostic factors in acute mesenteric ischemia

Between 1996 and 1999, 43 patients were operated upon for acute mesenteric ischaemia, in Kasr El-Aini hospital and Theodor Bilharz research institute. They included 17 patients [39.5%] with acute embolic mesenteric ischaemia, 9 patients [20.9%] with mesenteric thrombosis, 3 patients [7%] with non occlusive mesenteric ischaemia and 14 patients [32.6%] with mesenteric venous occlusion. 53.5% of the patients presented with classical clinical picture of mesenteric ischaemia Management plan was revascularization of the intestine whenever possible and resection of frank necrotic intestine. A second look operation was the rule when a revascularization procedure was done or when doubtful loop of intestine was left. The overall mortality was 30.2%

Upper thoracic sympathectomy "thoracoscopic versus supraclavicular approach''

With the outburst of the use of video-endoscopic assisted techniques in the early nineties, thoracoscopy was one of the most privileged domains. This is due to the already formed cavity maintained by the bony framework. This encouraged the performance of many of the "open sky" surgeries in the thoracic cavity to be included in a minimal invasive approach. In this study, we compared the results of upper thoracic sympathectomy that had been done either by the supraclavicular approach or by video-assisted thoracoscopic surgery. It was found that the thoracoscopic approach was easier to perform and less painful than the supraclavicular approach. Exposure was better, operative time and hospital stay were also reduced. The long-term success rate [one-year follow-up] was inure than 90% in both groups. As thoracoscopic sympathectomy resulted in achieving similar long-term results as the supraclavicular approach, thus the endoscopic approach is the operation of choice when upper thoracic sympathectomy is contemplated