What is microsurgical anastomosis?

A microsurgical transfer from a strict point of view implies a double vascular anastomosis less than 3 mm between vessels in the transferred tissue to the ones in the recipient area [1]. Super-microsurgery would refer to those situations in which anastomoses have a diameter between 0.3 and 0.8 mm [2].

What are microsurgical techniques?

Microsurgery is a surgical discipline that combines magnification with advanced diploscopes, specialized precision tools and various operating techniques. These techniques are primarily used to anastomose small blood vessels (arteries and veins) and to coapt nerves.

What is vascular anastomosis?

A vascular anastomosis is a surgical procedure that is used to connect vessels to each other. Vascular procedures that require an anastomosis include: Coronary artery bypass surgery to treat a blocked artery supplying the heart. Connecting an artery to a vein for hemodialysis access. Aneurysmectomy.

Which technique is used for microvascular repair?

Your surgeon uses an operating room microscope, specialized instruments, tiny needles, and ultrafine sutures to repair the blood vessels that are not visible to the human eye. Microscope having magnification of 5 to 40X is used for microsurgery.

Which needle is used for vascular anastomosis?

A blunt-point, round-body needle dilates rather than cuts, and is preferred in abdominal fascial closure, to prevent inadvertent visceral injury and bleeding. The taper-cut needle punctures and then dilates and is used for vascular anastomosis.

How do you hold a microsurgery instrument?

Hand Position: Keep your fingers in a ”writing” position. Your elbows, wrist, and ulnar side of your hands rest on the table. The forearm should be supinated. The instruments are held between your thumb, index, and middle fingers.

Where is microsurgery used?

Microsurgery can be used to take tissue from the leg or back to reconstruct a breast, reattach fingers or perform plastic or reconstructive surgery on ears, noses, scalps, hands, fingers, tongues, toes and other small body parts. Microsurgery is often used for complex cancer and trauma cases.

Who invented microsurgery?

The first microvascular surgery, using a microscope to aid in the repair of blood vessels, was described by vascular surgeon, Julius H. Jacobson II of the University of Vermont in 1960. Using an operating microscope, he performed coupling of vessels as small as 1.4 mm and coined the term microsurgery.

What are the three types of anastomoses?

There are three types: Arterioarterial anastomosis connects two arteries. Venovenous anastomosis connects two veins. Arteriovenous anastomosis connects an artery to a vein.

Why are vascular anastomoses so important?

Anastomoses occur normally in the body in the circulatory system, serving as backup routes for blood flow if one link is blocked or otherwise compromised. Anastomoses between arteries and between veins result in a multitude of arteries and veins, respectively, serving the same volume of tissue.

What type of suture is used for vascular anastomosis?

This technique of vascular anastomosis requires a double-armed polypropylene suture placed in a continuous fashion with perpendicular bites located 1 mm from the vessel edge and 1 mm apart.

What are the three types of anastomosis?

How are microsurgical techniques used for vascular anastomoses?

This microsurgical technique is usually used for the venous microanastomoses because the elasticity of the vein allows its eversion. The afferent vessel is introduced into the body of the cuff, without any rotation. Its vascular wall is then inverted over the external surface of the cuff using two forceps (Figure 8).

What are the main complications of vascular anastomosis?

Thrombosis, leakage and stenosis are the main complications and the only way to prevent them is continuous training and a perfect technique. In this chapter, we present the basic microsurgical techniques for vascular microanastomosis and introduce some alternatives to conventional anastomosis.

What kind of sutures are used for anastomosis?

Most microvascular anastomosis techniques should be completed with either 9–0 or 10–0 monofilament nylon sutures. Anastomosis of fingertip arteries or in children are sutured using supramicrosurgical techniques with 11–0 sutures.

Which is an example of a microsurgery procedure?

Examples of such structures are small blood vessels, nerves, and tubes. Microsurgery uses techniques that have been performed by surgeons since the early twentieth century, such as blood vessel repair and organ transplantation, but under conditions that make traditional vascular surgery difficult or impossible.