A Method for Reinforcing an Aortic-graft Anastomosis by a Strip of Dacron

Abstract

Introduction Dacron graft is cut as a spiral from the graft. The strip should be approximately 20 mm longer than the In surgery for abdominal aortic aneurysm (AAA) the transverse measure of the flattened aortic wall. The strip is secured to the ends of the rubber tubing by posterior aortic wall is commonly left intact when suturing the proximal aortic-graft anastomosis by the sutures (Fig. 1(a)) and is rotated down so that it is located behind the aorta. A little tension is applied to inlay technique. Often there is a well-developed “lip” of the posterior aortic wall which lends itself well for it by securing the tubing to a convenient object outside the wound, usually the retraction device. The posterior this method, but sometimes the aneurysm tapers down like a funnel. This makes it more difficult to get good row of 3–0 polypropylene sutures are placed using the parachute technique including the Dacron strip and secure suture bites of the posterior aortic wall. In 1986 when operating on a ruptured aortic an(Fig 1(b)). The anterior side of the anastomosis is sutured without reinforcement. After completion of eurysm I accidentally put some of the stitches in the posterior wall into a piece of rubber tubing that was the anastomosis the strip is cut where it emerges at the sides of the aorta. used to pull the posterior aortic wall forwards. This was discovered only when the anastomosis was completed and I had to leave a small piece of the tubing behind, fortunately with no long-term ill-effects since the patient lived for another 6 years. However, this Results experience led me to develop an alternate method which has proven to be quite useful. I have utilised this method for 36 aortic anastomoses and rarely need to put any extra stitches on the posterior side of the anastomosis. No obvious drawbacks such as venous damage have been observed and little time is needed for inserting the strip. Technique