Study evaluates the effects of laser tissue welding for spina bifida repair

A team of researchers from the Baylor College of Medicine (Houston, TX), IBEX (Logan, UT), and Laser Tissue Welding Inc. (also in Houston) is collaborating to evaluate the effects of laser tissue welding on the spinal cord and skin to potentially repair spina bifida, a birth defect where there is incomplete closure of the backbone and membranes around the spinal cord. The defect is associated with hydrocephalus (excessive accumulation of fluid on the brain), developmental delay, lifelong disability, and death.

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In a 30-day study of simulated spina bifida repair in rabbits, the researchers were interested to see if applying near-infrared (810 nm) laser energy to coagulate an indocyanine green (ICG)-tagged albumin compound would damage the underlying skin and/or spinal cord tissue. The researchers plan to use this substance for sealing incision lines in fetal surgical spina bifida repair procedures.

One of the most crucial aspects of a fetal repair is a watertight seal once the repair is complete. "Laser tissue welding is a promising technology that may allow a temporary seal over healing wounds that allows enough time for the regeneration of the skin underneath the albumin layer," explains Michael Belfort, MD, chairman and professor of obstetrics and gynecology at Baylor College of Medicine, obstetrician/gynecologist-in-chief of Texas Children's Pavilion for Women, and first author of a paper describing the work. "By sealing off the incision line with a natural substance that disintegrates over time, we feel that the suture line may heal without developing any leaks which would compromise the repair," he says.

The first step in this experimental process examined whether the heat from the laser (required to activate the liquid albumin and turn it into a solid) would damage the skin or spinal tissue under the skin. The research team chose a rabbit model because it is an accepted and cost-efficient animal model.

Now that the researchers know that laser energy is unlikely to damage spinal cord tissue, Belfort and his colleagues are planning on a fetal sheep experiment.

Full details of the work appear in the American Journal of Obstetrics and Gynecology; for more information, please visit http://dx.doi.org/10.1016/j.ajog.2016.11.971.