Trente ans de microanastomoses vasculaires assistées par laser des perspectives cliniques?

Introduction: Since the first studies by Jain and Gorisch (1979), laser-assisted anastomoses have been steadily developed to a stage where clinical use is within reach. The laser-assisted vascular microanastomosis (LAMA) procedure is performed more quickly than conventional anastomosis, the surgically induced vessel damage is limited, and reduced bleeding after unclamping is observed. Material and methods: A Medline literature search, for the January 1979 to February 2010 period, was performed to review articles focusing on the LAMA technique. Results: The search yielded a total of 354 publications, of which 87 were relevant: 82 were animal series and five clinical studies. Microsurgical techniques and principal characteristics of LAMA in patients are the focus of the analysis. This study discusses the technological innovations and new orientations in laser welding. Conclusion: The first two clinical series using the 1.9-μm diode laser appear promising. Technical innovation will most likely lead to greater ease of use of the laser handpiece in the operating room.