scholarly journals Training model for the intraluminal continuous suturing technique for microvascular anastomosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zongyu Xiao ◽  
Madjid Samii ◽  
Ji Wang ◽  
Qi Pan ◽  
Zhimin Xu ◽  
...  
Keyword(s):  
Abdominal Aorta ◽  
Posterior Wall ◽  
Training Model ◽  
Microvascular Anastomosis ◽  
Silicone Tube ◽  
Iliac Arteries ◽  
Suturing Technique ◽  
End To End ◽  
Suturing Techniques ◽  
Common Iliac Arteries

AbstractMicrovascular anastomosis is a critical procedure in cerebral bypass surgeries. In some rare cases, the extraluminal interrupted technique is not optimal because the vessels are immobile and cannot be rotated, and anastomosis can be performed effectively through the intraluminal continuous suturing technique. The authors reported the application of the intraluminal continuous suturing technique in microanastomosis training with silicone tube, rat’s common iliac arteries and abdominal aorta. A silicone tube with a diameter of 1.5 mm was used to practice microanastomosis in intraluminal continuous suturing technique. Then the technique was applied in side-to-side, end-to-side anastomoses of common iliac arteries and the end-to-end abdominal aorta anastomoses of rat. The suturing time and patency rates were compared with an alternative intraluminal continuous suturing technique and one-way-up interrupted suturing technique in silicone tube and rat vessel anastomoses. The intraluminal continuous suturing technique could be gained through practicing with silicone tube, and the technique has also been demonstrated effective in side-to-side, end-to-side anastomoses of common iliac arteries of rat and the abdominal aorta end-to-end anastomoses. In all the animal experimental groups with different suturing techniques, there was no difference between the patency rates, all the immediate patency rate was 100%. There was no significant suturing time difference between the two intraluminal continuous suturing techniques, but the two intraluminal continuous suturing techniques were faster than the interrupted technique. The intraluminal continuous suturing technique described in the study could be used as an efficient method for side-to-side, end-to-side and end-to-end anastomosis, especially under the situation the posterior wall of the anastomosis could not be rotated. Proficiency of the technique could be achieved through practicing in laboratory with silicone tube and live animals.

scholarly journals Variations in the aortic - common iliac bifurcation in man - a cadaveric study

2013 ◽  
Vol 02 (02) ◽  
pp. 056-060
Author(s):  
Maneesha Sharma ◽  
Tripta Sharma ◽  
Richhpal Singh
Keyword(s):  
Abdominal Aorta ◽  
Abdominal Cavity ◽  
Lumbar Vertebra ◽  
Anatomical Variations ◽  
Iliac Arteries ◽  
Medical College ◽  
Great Vessels ◽  
Exact Position ◽  
Vertebral Bodies ◽  
Common Iliac Arteries

Abstract Background and aims: The abdominal aorta usually terminates at the level of L4 vertebral body into common iliac arteries. With the present day advancements in vascular surgery and neurological surgeries involving approach to lumbar vertebral bodies, we need to know any variations from this normal course. So, the present study aimed at knowing the anatomical variations in the termination of abdominal aorta and in common iliac arteries which might prove to be of some help in some of such surgeries. Material and methods: The study was conducted on 35 adult (29 males and 6 females) embalmed cadavers obtained from anatomy departments of Govt. Medical college, Amritsar and Gian Sagar Medical college, Ramnagar, Punjab. The abdominal cavity was opened, peritoneum stripped off from aorta at its bifurcation, variations in its termination, common iliac arteries and their branches were carefully observed and recorded. Results: In 54.29% cases the level of aortic bifurcation was found opposite 4th Lumbar vertebra, in the rest it was variable between L3 and L5 vertebra. Conclusions: These variations may lead to some trouble during vertebral surgeries, making it essential to investigate and locate the exact position of great vessels before the commencement of surgery.

Severe obstructive calcifications affecting the descending and suprarenal abdominal aorta without coexisting peripheral atherosclerotic disease – coral reef aorta

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 206-208 ◽  
Author(s):  
Teebken ◽  
Pichlmaier ◽  
Kühn ◽  
Haverich
Keyword(s):  
Coral Reef ◽  
Abdominal Aorta ◽  
Bypass Graft ◽  
Retroperitoneal Approach ◽  
Rare Form ◽  
Iliac Arteries ◽  
Descending Aorta ◽  
Aortic Replacement ◽  
Thoracic And Abdominal ◽  
Common Iliac Arteries

The case of a 58-year-old woman with leg claudication due to a very rare form of atherosclerosis affecting the descending thoracic and abdominal aorta – known as coral reef aorta – without involvement of the femoro-distal vessels is reported. The patient was treated with a polyester bifurcation graft from the proximal descending aorta to both common iliac arteries via a left dorsal minithoracotomy and a second left retroperitoneal approach. This unusual approach was chosen instead of direct aortic replacement in order to prevent paraplegia. In case of future visceral or left renal malperfusion the diseased artery can be connected to the prosthesis directly or by the use of an additional bypass graft. This would not be the case with a conventional axillo-bifemoral graft.

Needle Parking Interrupted Suturing Technique for Microvascular Anastomosis: A Technical Note

2021 ◽  
Author(s):  
Shyle H Mehta ◽  
Evgenii Belykh ◽  
Dara S Farhadi ◽  
Mark C Preul ◽  
Ken-ichiro Kikuta
Keyword(s):  
In Vitro Study ◽  
Senior Author ◽  
Technical Note ◽  
Vitro Study ◽  
Microvascular Anastomosis ◽  
Knot Tying ◽  
Suturing Technique ◽  
Cerebrovascular Surgery ◽  
Suturing Techniques

Abstract BACKGROUND Interrupted and continuous suturing are 2 common techniques for microvascular anastomosis in cerebrovascular surgery. One of the technical complexities of interrupted suturing includes the risk of losing the needle in between interrupted sutures during knot tying, which may result in unnecessary movements and wasted time. OBJECTIVE To report a new needle parking technique for microvascular anastomosis that addresses a needle control problem during interrupted suturing. METHODS The needle parking technique involves puncturing both vessel walls at the site of the next provisional suture and leaving the needle parked in place while the knots at the first suture are being made. The thread is then cut, the needle is pulled through, and the process is repeated. Illustrative cases in which the needle parking technique was used are presented. We also compared time of anastomosis completion between the conventional interrupted, needle parking interrupted, and continuous suturing techniques during an in vitro study on standardized artificial vessels. RESULTS This technique is being used successfully by the senior author for various cerebrovascular bypass surgeries. The in vitro study demonstrated that the needle parking technique can be significantly faster than the conventional interrupted suturing technique and may be as fast as continuous suturing. CONCLUSION Needle parking technique is a modification of conventional interrupted suturing and solves the problem of losing the needle during knot tying. This technique is simple, prevents unnecessary movements, and may result in a faster anastomosis time.

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