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Microvascular anastomosis

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https://www.readbyqxmd.com/read/28608190/endoluminal-laser-assisted-vascular-anastomosis-an-in-vivo-study-in-a-pig-model
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28452166/dorsal-scapular-artery-as-a-recipient-vessel-in-the-vessel-depleted-neck-during-free-tissue-transfer-in-head-and-neck-reconstruction
#15
Andrew J Rosko, Jesse T Ryan, Eric J Wizauer, Mohannad Ibrahim, Ashok Srinivasan, Chaz L Stucken, Matthew E Spector
BACKGROUND: The vessel-depleted neck poses a unique challenge to the microvascular surgeon. Using 3D modeling and cadaveric dissection, we describe the approach and advantages of a known but less frequently used recipient vessel, the dorsal scapular artery, during free tissue transfer. METHODS: Three patients with vessel-depleted necks required reconstruction with free tissue transfer. The dorsal scapular artery was used as a recipient vessel. Three-dimensional anatomic models were created and cadaveric dissections were performed to characterize the anatomy...
July 2017: Head & Neck
https://www.readbyqxmd.com/read/28407264/microvascular-anastomosis-simulation-using-a-chicken-thigh-model-interval-versus-massed-training
#16
Stephen Schoeff, Brian Hernandez, Derek J Robinson, Mark J Jameson, David C Shonka
OBJECTIVES/HYPOTHESIS: To compare the effectiveness of massed versus interval training when teaching otolaryngology residents microvascular suturing on a validated microsurgical model. STUDY DESIGN: Otolaryngology residents were placed into interval (n = 7) or massed (n = 7) training groups. The interval group performed three separate 30-minute practice sessions separated by at least 1 week, and the massed group performed a single 90-minute practice session. Both groups viewed a video demonstration and recorded a pretest prior to the first training session...
April 13, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28387172/review-of-surgical-techniques-of-experimental-renal-transplantation-in-rats
#17
Badri Shrestha, John Haylor
Microvascular surgical techniques of renal transplant in rats have evolved over the past 5 decades to achieve successful rat renal transplant; these modifications have included surgical techniques to address the anatomic variations in the renal blood vessels and those to reduce ischemic and operation durations. Here, we review the surgical techniques of renal transplant in rats and evaluate the advantages and disadvantages of individual techniques of vascular and ureteric anastomoses. For this review, we performed a systematic literature search using relevant medical subject heading terms and included appropriate publications in the review...
April 6, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28383474/an-intraluminal-stent-facilitates-light-activated-vascular-anastomosis
#18
Prabhu Senthil-Kumar, Joanna H Ng-Glazier, Mark A Randolph, Hatice Bodugoz-Senturk, Orhun K Muratoglu, Irene E Kochevar, Jonathan M Winograd, Robert W Redmond
BACKGROUND: Photochemical tissue bonding (PTB) is a sutureless, light-activated technique that produces a watertight, microvascular repair with minimal inflammation compared to standard microsurgery. However, it is practically limited by the need for a clinically viable luminal support system. The aim of this study was to evaluate a hollow biocompatible stent to provide adequate luminal support to facilitate vascular anastomosis using the PTB technique. METHODS: Forty rats underwent unilateral femoral artery transection...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28340671/unique-techniques-or%C3%A2-approaches-in-microvascular-and-microlymphatic-surgery
#19
REVIEW
Jin Bo Tang, Luis Landín, Pedro C Cavadas, Alessandro Thione, Jing Chen, Gemma Pons, Jaume Masià
Several methods can be used for identifying tissues for transfer in donor-site-depleted patients. A fillet flap can be temporarily stored in other parts of the body and transferred back to the site of tissue defect, including covering the amputated stump of the lower extremity. Human arm transplant is rare and has some unique concerns for the surgery and postsurgical treatment. Cosmetics of the narrow neck of transferred second toes can be improved with insertion of a flap. Lymphedema of the breast after cancer treatment can be diagnosed with several currently available imaging techniques and treated surgically with lymphaticovenous anastomosis...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28280670/a-comprehensive-approach-to-lower-extremity-free-tissue-transfer
#20
Lee L Q Pu
BACKGROUND: The purpose of this study was to introduce a comprehensive approach to lower extremity free-tissue transfer and report the clinical outcome that has been achieved with this approach. METHODS: The comprehensive approach developed by the author includes patient selection, flap selection, selection of the recipient vessels, flap dissection, flap preparation, microvascular anastomosis, flap inset, immediate postoperative care, intermediate postoperative care, and further follow-up care...
February 2017: Plastic and Reconstructive Surgery. Global Open
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