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Microvascular anastomosis

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https://www.readbyqxmd.com/read/28699660/binding-of-indocyanine-green-in-polycaprolactone-fibers-using-blend-electrospinning-for-in-vivo-laser-assisted-vascular-anastomosis
#1
Annemarie Schönfeld, Zacharia Mbäıdjol Kabra, Mihai Constantinescu, Dieter Bosshardt, Michael H Stoffel, Kirsten Peters, Martin Frenz
BACKGROUND AND OBJECTIVE: The clinical application of laser-assisted vascular anastomosis is afflicted by unreliable and low bonding strengths as well as tedious handling during microvascular surgery. The challenge to be met arises from the flow-off of the chromophore during soldering that changes the absorption and stains the surrounding tissue, leading to an uncontrollable thermal damage zone. In this study, we investigated the feasibility to produce an indocyanine green (ICG)-loaded patch by electrospinning and tested its applicability to both in vitro and in vivo microvascular laser soldering...
July 12, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28673805/a-new-synthetic-model-for-microvascular-anastomosis-training-a-randomized-comparative-study-between-silicone-and-polyvinyl-alcohol-gelatin-tubes
#2
Michael Atlan, Alexandre G Lellouch, Josette Legagneux, Marc Chaouat, Alain-Charles Masquelet, Didier Letourneur
INTRODUCTION: Assessment of a resident's microsurgical competency with the rodent model remains the current gold standard. However, cost and ethical issues related to animal welfare may limit training opportunities. Therefore, synthetic alternatives such as silicone tubes have been developed to provide easy access to training, shorten the learning curve, and have been incorporated into microsurgical courses as a low-fidelity model for basic skills acquisition. This study compares the use of polyvinyl alcohol (PVA) gelatin tubes with silicone for resident microsurgical training...
June 30, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28655079/-pathological-insights-of-radiotherapy-related-damage-to-surgical-margin-after-preoperative-radiotherapy-in-patients-with-rectal-cancer
#3
Q H Zhong, P H Wu, Q Y Qin, Y Y Kuang, T H Ma, H M Wang, Y X Zhu, D C Chen, J P Wang, L Wang
Objective: To investigate the effect of irradiation to anastomosis from preoperative radiotherapy for patients with rectal cancer by studying the pathological changes. Methods: In this retrospective study, patients enrolled in the FOWARC study from January 2011 to July 2014 in the Sixth Affiliated Hospital of Sun Yat-Sen University were included. In the FOWARC study, enrolled patients with local advanced rectal cancer were randomly assigned to receive either neoadjuvant chemo-radiotherapy or chemotherapy. Among these patients, 23 patients were selected as radiation proctitis (RP)group, who fulfilled these conditions: (1) received neoadjuvant chemo-radiotherapy followed by sphincter-preserving surgery; (2) developed radiation proctitis as confirmed by preoperative imaging diagnosis; (3) had intact clinical samples of surgical margins...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28648580/flowmetry-evolution-in-microvascular-surgery-a-systematic-review
#4
REVIEW
Georgios Pafitanis, Maria Raveendran, Simon Myers, Ali M Ghanem
This review aims to provide a summary of the flowmeter devices used in microvascular surgery and assesses their contribution to improving the clinical outcomes of free tissue transfer. Flowmeters are widely accepted as the standard method of intraoperative assessment of the patency of coronary vascular anastomoses, providing thresholds that predict outcome. There is limited evidence regarding the use of flow measurements in plastic surgery microvascular anastomoses; however, flowmetry appears to have some role in postoperative free flap monitoring and prevention of complications...
May 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28647662/microsurgical-bypass-training-rat-model-part-1-technical-nuances-of-exposure-of-the-aorta-and-iliac-arteries
#5
Ali Tayebi Meybodi, Michael T Lawton, Pooneh Mokhtari, Sonia Yousef, Sirin Gandhi, Arnau Benet
BACKGROUND AND OBJECTIVE: Animal models using rodents are frequently used for the purpose of practicing microvascular anastomosis - an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in two consecutive articles...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28634954/3d-anastomosed-microvascular-network-model-with-living-capillary-networks-and-endothelial-cell-lined-microfluidic-channels
#6
Xiaolin Wang, Duc T T Phan, Steven C George, Christopher C W Hughes, Abraham P Lee
This protocol describes detailed practical procedures for generating 3D intact and perfusable microvascular network that connects to microfluidic channels without appreciable leakage. This advanced 3D microvascular network model incorporates different stages of vascular development including vasculogenesis, endothelial cell (EC) lining, sprouting angiogenesis, and anastomosis in sequential order. The capillary network is first induced via vasculogenesis in a middle tissue chamber and then EC linings along the microfluidic channel on either side serve as artery and vein...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28608190/endoluminal-laser-assisted-vascular-anastomosis-an-in-vivo-study-in-a-pig-model
#7
Zacharia Mbaidjol, David Kiermeir, Annemarie Schönfeld, Jörg Arnoldi, Martin Frenz, Mihai A Constantinescu
Microvascular surgery is time consuming and requires high expertise. Laser-assisted vascular anastomosis (LAVA) is a promising sutureless technique that has the potential to facilitate this procedure. In this study, we evaluate the handling of our soldering material and the 1-week patency rate in a porcine model. Six pigs were subjected to LAVA. For each pig, the saphenous artery on one side was transected while the contralateral side was used as control. A porous polycaprolactone scaffold soaked in 40% (w/w) bovine serum albumin solution in combination with 0...
June 12, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28599906/affordable-microsurgical-training-system-for-a-beginning-neurosurgeon-how-to-realize-the-self-laboratory
#8
Sang-Bong Chung, Jiwook Ryu, Yeongu Chung, Sung Ho Lee, Seok Keun Choi
OBJECTIVE: Based on our experience, this report provides detailed information about how to realize a self-laboratory including cost-effective microsurgical instruments especially for the novice trainee. METHODS: Our training model was designed to allow microsurgical practice to be performed in a cost-effective way. A used stereoscopic microscope was prepared for microsurgical training. A sufficient working distance for microsurgical practice was obtained by attaching an auxiliary objective lens...
June 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28594742/outcomes-of-lymphedema-microsurgery-for-breast-cancer-related-lymphedema-with-or-without-microvascular-breast-reconstruction
#9
Holger Engel, Chia-Yu Lin, Jung-Ju Huang, Ming-Huei Cheng
OBJECTIVE: This study investigated the outcome of lymphedema microsurgery with or without microsurgical breast reconstruction for breast cancer-related lymphedema (BCRL). BACKGROUND: Complete decongestive therapy, lymphovenous anastomosis, and vascularized lymph node flap transfer are the 3 major treatment modalities for BCRL. Releasing axillary contracture and transferring a free flap may potentially improve the BCRL. METHODS: Between 2004 and 2015, 124 patients with BCRL who underwent 3 treatment modalities without or with microsurgical breast reconstruction were included in this study as groups I and II, respectively...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28581249/the-robotic-ent-microsurgery-system-a-novel-robotic-platform-for-microvascular-surgery
#10
Allen L Feng, Christopher R Razavi, Pranav Lakshminarayanan, Zaid Ashai, Kevin Olds, Marcin Balicki, Zhen Gooi, Andrew T Day, Russell H Taylor, Jeremy D Richmon
OBJECTIVE: Assess the feasibility of a novel robotic platform for use in microvascular surgery. STUDY DESIGN: Prospective feasibility study. SETTING: Robotics laboratory. METHODS: The Robotic ENT (Ear, Nose, and Throat) Microsurgery System (REMS) (Galen Robotics, Inc., Sunnyvale, CA) is a robotic arm that stabilizes a surgeon's instrument, allowing precise, tremor-free movement. Six microvascular naïve medical students and one microvascular expert performed microvascular anastomosis of a chicken ischiatic artery, with and without the REMS...
June 5, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28560125/learning-microvascular-anastomosis-in-low-socioeconomic-vascular-models-during-residency
#11
Karuna Tamrakar
Microvascular anastomosis procedure has become an essential practice for the management of most neurovascular diseases. Increasing use of neurosurgical techniques necessitates intensive laboratory training in microsurgery. Umbilical artery is used for quantifiable representation to set up microvascular anastomosis model for the beginners. These arteries are found to be between 4 and 5 mm in diameter. Chicken wings are set up as second anastomosis model. Five to six centimeter long brachial artery extracted from a chicken is measured approximately 1-2 mm in diameter...
April 27, 2017: Curēus
https://www.readbyqxmd.com/read/28538566/predicting-thrombosis-formation-in-1-mm-diameter-arterial-anastomoses-with-transit-time-ultrasound-technology
#12
Gabrielle Shaughness, Collin Blackburn, Alberto Ballestín, Yelena Akelina, Jeffrey A Ascherman
BACKGROUND: Thrombosis is a common source of failure in anastomoses, flaps, and vascular grafts. Ensuring vessel patency is critical to the success of microvascular procedures. Any tool that can accurately predict the patency of an anastomosis intraoperatively would enable the surgeon to detect and correct flow restrictions while the patient is still in the operating room. METHODS: The authors used transit-time ultrasound technology in this pilot study to investigate whether a minimal cutoff value for quantitative postoperative blood flow (in milliliters per minute) could be established that would reliably predict sustained vessel patency at 24 hours postoperatively...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28524130/-creation-of-extracranial-intracranial-microvascular-anastomosis-under-regional-anesthesia-a-case-report-and-a-review-of-the-literature
#13
D Yu Usachev, V A Lukshin, A V Shmigel'skiy, A D Akhmedov, A D Sosnin, K A Kozlova
The article describes a case of successful surgical treatment of an 81-year-old male patient with symptomatic occlusion of the internal carotid artery that led to severe impairment of cerebral hemodynamics and was accompanied by severe gait and equilibrium disorders. Given the patient's age and his positive medical history, he underwent surgery for the creation of an extracranial-intracranial microvascular anastomosis under regional anesthesia, with spontaneous breathing and a baseline level of consciousness being maintained...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28472839/development-and-evaluation-of-a-simulation-model-for-microvascular-anastomosis-training
#14
Ross E Willis, John Wiersch, Andrew J Adams, Mohammed J Al Fayyadh, Robert A Weber, Howard T Wang
No abstract text is available yet for this article.
May 4, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28468146/microsurgical-replantation-of-total-avulsed-scalp-extending-the-limits
#15
Yunbo Jin, Chen Hua, Xiaojie Hu, Hui Chen, Gang Ma, Yun Zou, Bin Chen, Dongze Lyu, Mathias Tremp, Xiaoxi Lin
BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28467662/impact-of-venous-outflow-tract-on-survival-of-osteocutaneous-free-fibula-flaps-for-mandibular-reconstruction-a-14-year-review
#16
Eric I Chang
BACKGROUND: The principle reconstructive modality for segmental mandibulectomy defects is the osteocutaneous free fibula flap. Preoperative CT angiography has been recommended to assess the quality of arterial inflow to the flap and donor limb. However, the impact of the venous system on flap viability has not been explored. METHODS: A retrospective review of all patients undergoing free fibula flap mandible reconstruction was performed at a single tertiary cancer center from 2002 to 2015...
July 2017: Head & Neck
https://www.readbyqxmd.com/read/28465039/use-of-couplers-for-vascular-anastomoses-in-601-free-flaps-for-reconstruction-of-defects-of-the-head-and-neck-technique-and-two-year-retrospective-clinical-study
#17
A Assoumane, L Wang, K Liu, Z-J Shang
We describe our experience with the use of 854 couplers for venous or arterial anastomoses, or both, in 601 free flaps for reconstruction of defects of the head and neck. We reviewed 601 patients who had had free flaps (with the microvascular anastomoses being made with couplers in 519) between July 2013 and December 2015. Personal details, and clinical data including the site of the defect, the tumour excised, the types of flaps, the size of the couplers, the method of anastomosis (venous or arterial) in which the coupler was used, and postoperative complications were recorded...
April 29, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28462437/clinical-assessment-of-reconstruction-involving-gastric-pull-up-combined-with-free-jejunal-graft-after-total-pharyngolaryngoesophagectomy
#18
Hiroshi Miyata, Keijiro Sugimura, Masaaki Motoori, Yoshiyuki Fujiwara, Takeshi Omori, Masahiro Mun, Masayuki Ohue, Masayoshi Yasui, Norikatsu Miyoshi, Takashi Fujii, Hiroki Tajima, Tomoyuki Kurita, Masahiko Yano
BACKGROUND: Total pharyngolaryngoesophagectomy (PLE) is used as a curative treatment for synchronous laryngopharyngeal and thoracic esophageal cancer or for multiple cancers in the cervical and thoracic esophagus. Gastric pull-up is commonly used after PLE, but postoperative complications are common. The present study evaluated these procedures in patients with esophageal cancer. METHODS: Fourteen patients (7 with synchronous pharyngeal and thoracic esophageal cancer, 4 with synchronous cervical and thoracic esophageal cancer, and 3 with cervicothoracic esophageal cancer) underwent reconstructive surgery after PLE involving gastric pull-up combined with free jejunal graft between 2004 and 2015...
May 1, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28458967/improved-head-and-neck-free-flap-outcome-effects-of-a-treatment-protocol-adjustment-from-pre-to-postoperative-radiotherapy
#19
Martin Halle, Bjorn O Eriksson, Ann-Charlott Docherty Skogh, Pehr Sommar, Lalle Hammarstedt, Caroline Gahm
BACKGROUND: The impact of preoperative radiotherapy on microvascular reconstructive surgery outcome has been a subject of debate. However, data are conflicting and often dependent on local treatment protocols. We have studied the effects of radiotherapy in a unique, single-center setting where a treatment protocol change was undertaken from pre- to postoperative radiotherapy administration for microsurgical head and neck reconstructions. METHODS: A cohort study was conducted for 200 consecutive head and neck free flap cases, where 100 were operated on before and 100 after the treatment protocol adjustment in 2006...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28457413/hepatic-artery-thrombosis-after-liver-transplantation-five-year-experience-at-the-state-university-of-campinas
#20
C H Puliti Reigada, E C de Ataide, T de Almeida Prado Mattosinho, I F S F Boin
BACKGROUND: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. METHODS: This was a retrospective study from January 2007 to December 2012 at the State University of Campinas. Variables analyzed were age, sex, cold and warm ischemia times, underlying disease, presence of hepatocellular carcinoma, Model for End-Stage Liver Disease (MELD) score, arterial anatomic variation in the graft, cytomegalovirus (CMV) infection, rejection, biliary complications, retransplantation rate, and survival...
May 2017: Transplantation Proceedings
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