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Microvascular anastomosis

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https://www.readbyqxmd.com/read/28820839/smaller-diameter-anastomotic-coupling-devices-have-higher-rates-of-venous-thrombosis-in-microvascular-free-tissue-transfer
#1
Summer E Hanson, Matthew B Mitchell, Nihanth Palivela, S Andrew Peng, Lei Feng, Rene D Largo, Charles E Butler, Patrick B Garvey
BACKGROUND: Smaller anastomotic coupling devices may increase the risk of complications in free flap reconstructions; however, the relationship between coupler size and venous thrombosis rates has not been adequately evaluated. We hypothesized that smaller-diameter coupling devices are associated with higher rates of venous thrombosis than larger diameter devices in free tissue transfer. METHODS: We retrospectively reviewed data prospectively entered into a central departmental database for all patients who underwent microsurgical free tissue transfer at our institution in 2001-2013...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28812257/robotic-assisted-microvascular-surgery-skill-acquisition-in-a-rat-model
#2
Nicholas S Clarke, Johnathan Price, Travis Boyd, Stefano Salizzoni, Kenton J Zehr, Alejandro Nieponice, Pietro Bajona
Microsurgery is a technically demanding field with long learning curves. Robotic-assisted microsurgery has the ability to decrease these learning curves. We, therefore, sought to assess the feasibility of robotic-assisted microvascular surgery in a rat model, and whether this could be translated into a worthwhile skills acquisition exercise for residents. Twenty-eight rats underwent microvascular anastomosis. Procedures were performed by a trained microvascular surgeon with no robotic experience (n = 14), or a trained robotic surgeon with no microvascular experience (n = 14)...
August 10, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28806848/comparison-of-live-rat-femoral-artery-model-with-intraoperative-microvascular-anastomosis
#3
Mark V Schaverien, Charles E Butler, Hiroo Suami, Jun Liu, Jesse C Selber
No abstract text is available yet for this article.
August 14, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28799442/the-use-of-innervated-radial-artery-superficial-palmar-branch-perforator-free-flap-for-complex-digital-injuries-reconstruction
#4
Zhenglin Chi, Georgios Pafitanis, Luis Eduardo Parra Pont, Roshan Vijayan, Stefano Marcelli, Weiyang Gao, Zan Li, Xiao Zhou, Dajiang Song, Peng Yang
Loco-regional flaps have been widely used for the reconstruction of digital injuries without requiring microvascular anastomosis, however, they result in scarring and compromised functional outcomes. This study demonstrates our experience utilizing the innervated radial artery superficial palmar branch (RASPB) perforator free flap for complex digital injury reconstruction. From May 2007 to March 2014, the innervated RASPB perforator free flap was used to reconstruct 79 distal complex hand and digital soft tissue defects of which 14 were used to re-vascularise the distal digit in a flow-through fashion...
August 11, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28742116/sutureless-microvascular-anastomosis-assisted-by-an-expandable-shape-memory-alloy-stent
#5
Noriko Saegusa, Shunji Sarukawa, Kunihiro Ohta, Kensuke Takamatsu, Mitsuhiro Watanabe, Takashi Sugino, Masahiro Nakagawa, Yasuto Akiyama, Masatoshi Kusuhara, Kazuo Kishi, Keita Inoue
Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5-10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology...
2017: PloS One
https://www.readbyqxmd.com/read/28739457/distal-ulnar-artery-aneurysm-repair-by-end-to-end-technique-a-case-report
#6
Attilio Cotroneo, David Barillà, Felice Armienti, Gian Luca Martinelli, Marco Diena
We report the case of a 33-year-old man presented with a post-traumatic 20mm left ulnar artery aneurysm without intraluminal thrombus in the left hypotenar eminence. The patient reported left hand paraesthesia. Because of symptoms and the embolic risk we decide to plan an aneurysm resection and an interposition graft with inverted basilic vein for adequacy diameter (∼ 2mm), but an end-to-end anastomosis was performed instead. We think that the post traumatic distal artery aneurysm could be treated without a by-pass but, after a meticulous anatomic dissection, with a microvascular anastomosis between the artery stumps...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28728324/the-chicken-thigh-adductor-profundus-free-muscle-flap-a-novel-validated-non-living-microsurgery-simulation-training-model
#7
Georgios Pafitanis, Yasmine Serrar, Maria Raveendran, Ali Ghanem, Simon Myers
BACKGROUND: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28699660/binding-of-indocyanine-green-in-polycaprolactone-fibers-using-blend-electrospinning-for-in-vivo-laser-assisted-vascular-anastomosis
#8
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
#9
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
#10
RANDOMIZED CONTROLLED TRIAL
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
#11
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
#12
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
#13
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
#14
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...
August 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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