Sutureless Microvascular Anastomosis: Literature Review

Vlad Ilie,Elias Moisidis,Roger Haddad

doi:10.24983/scitemed.imj.2019.00112

Vlad Ilie, Elias Moisidis + Show 1 more

Open Access

https://doi.org/10.24983/scitemed.imj.2019.00112

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Abstract

Traditionally, suturing techniques have been the mainstay for microvascular anastomoses, but owing to its technical difficulty and labour intensity, considerable work has gone into the development of sutureless microvascular anastomoses. In this review, the authors take a brief look at the developments of this technology through the years, with a focus on the more recent developments of laser-assisted vascular anastomoses, the unilink system, vascular closure staples, tissue adhesives, and magnets. Their working principles, with what has been found concerning their advantages and disadvantages are discussed.

Highlights

In order to enable the surgical procedure to move from a macroscopic to a microscopic one, the use of fine instruments is necessary
Ever since the 1900’s, research had started on other methods of vascular anastomosis and still being continued till this day, concerning the use of lasers, tissue adhesives, extraluminal cuffing rings, and everting pinned-ring devices, metallic stapling devices, and magnets
We identified four clinical series using 1950-nm diode laser [16,17,18,19], which were performed after extensive animal experience [20]

Summary

INTRODUCTION

In order to enable the surgical procedure to move from a macroscopic to a microscopic one, the use of fine instruments is necessary. Magnetic energy was introduced in vascular surgery by Obora in 1978 using magnetic rings and hollow cogwheel-shaped metal devices held together by magnetic energy to anastomose vessels up to 2 mm [1,2] The advantages of these sutureless devices are many, including good contact between the intima, higher patency rates (because there was no exposure of anastomotic material into the lumen), shorter operating times, and less need for microsurgical training, making it increasingly feasible for the less experienced surgeon. Some devices, because they are simple, efficacious, and significantly faster than suturing material, are, in some units, the preferred method of microvascular anastomosis. All the specific advantages and disadvantages of the techniques are discussed in the review article

LITERATURE SEARCH

FIBRIN GLUE

UNILINK SYSTEM

VASCULAR CLOSURE STAPLES

Findings

TISSUE ADHESIVES