Growing Cava Vein Anastomosis: Comparison of Cross-Clamping and Suture Times Using VCS Metallic Clips, Interrupted Nonabsorbable, or Continuous Absorbable Suturing Techniques

Abstract

The latest generation in titanium clip application systems, the AnastoClip Vessel Closure System (VCS; LeMaitre Vascular, Burlington, MA), allows surgeons to perform vascular anastomosis more easily and faster than conventional sutures. This system may become the option of choice for vascular reconstruction in pediatric surgery where, as in the case transplant surgery, decreasing vascular occlusion times may influence outcome. The aim of this study was to determine whether VCS metallic clips would allow shorter anastomosis times than conventional interrupted polypropylene or running polyglycolic acid suturing in end-to-end anastomosis performed in the abdominal cava of young pigs. Thirty-two domestic swine, 45days old, were used for this study. All animals were subjected to an end-to-end anastomosis in the abdominal cava. VCS clips are easier to use for the surgeon, significantly decreasing cross-clamping time in caval anastomosis (VCS 10.33±1.75min vs. interrupted polypropylene sutures 46.00±6.16min vs. continuous polyglycolic acid sutures 18.16±1.47min). VCS clips significantly decrease the time needed for performing an end-to-end anastomosis in the abdominal cava, decreasing cross-clamping time when compared to interrupted polypropylene or running polyglycolic acid sutures.