Congenital Deformities Research Articles

Analysis of Health and Demographic Data of the Rural Population of the Aiyrtau District

The task of restructuring the network of medical organizations, taking into account regional characteristics, in order to ensure maximum accessibility of medical care, fell into the national project "Quality and affordable healthcare for every citizen "Healthy Nation". The purpose of the study: to assess the availability of medical care for the rural population based on the analysis of medical and demographic indicators of the Aiyrtau district. Methods. In this study, in order to analyze the medical and demographic situation of the rural population of the Aiyrtau district, as well as to determine the accessibility of the healthcare system for the rural population, statistical data, accounting and reporting documentation of medical organizations were studied. Demographic indicators, morbidity rates, the number of medical institutions in the region, the equipment ofmedical organizations, the provision of medical workers, etc. were analyzed. Results. Medical and demographic indicators do not reach republican values. The overall mortality rate (15.87 per 1000 people) is 1.6 times higher than in the republic (9.53 per 1000 population). The birth rate (12.27 per 1000 population) is 1.9 times lower than the republican level (23.41 per 1000 population). Over the past 5 years (from 2017 to 2021), the birth rate in the region has decreased by 6.4% from 13.11 to 12.27 per 1000 population (Kazakhstan - a decrease of 7.5%). When studying the mortality rates of the population, a similar situation is observed, when in 2021 there was an increase to 15.07, and in 2022 it decreased by 10.6% to 13.46 per 1000 population. The total number of diseases was 23710, the leading position, as well as throughout the country, is occupied by respiratory diseases - 9519 (40.1%), followed by diseases of the circulatory system - 5348 (22.5%), endocrine diseases - 1844 (8%), followed by diseases of the digestive system - 880 (5.1%), neoplasms - 522, infectious and parasitic diseases - 427, injuries, poisoning - 422 (2.7%) and congenital anomalies (malformations), deformities and chromosomal disorders - 188 (1.79%). The healthcare system of the region is represented by 19 hospitals, 63 outpatient organizations (58 outpatient clinics, 5 outpatient clinics, including AIDS center, regional dentistry, etc.), 41 feldsher-obstetric and 403 medical centers. The bed fund of state medical organizations is 3223 beds. The district hospital with a polyclinic and a hospital is equipped with 85 beds for a round-the clock stay and 31 beds for a day stay, it has 10 medical outpatient clinics, 3 feldsher-obstetric stations, 46 medical stations. Conclusions. The results of the study show that the incidence among the rural population remains high. The main problems of the rural healthcare system, which significantly affect the availability of medical care for the rural population, are undeveloped infrastructure, under equipped medical organizations, which in turn leads to low detection of pathology, late diagnosis and treatment. There is also a shortage of personnel, especially a shortage of narrow specialists, which leads to low availability of specialized medical care.

The challenges associated with fused deposition modelling of high-density polyethylene for facial augmentation implants: a review

High-density polyethylene (HDPE) implants are widely employed in craniomaxillofacial augmentation surgery because of their unique ability to bond with tissues for bone repair and functional recovery of the facial areas which are affected by acquired or congenital facial deformities. The direct manufacturing of HDPE implants as patient-specific implants through fused deposition modelling (FDM) has the potential to enhance their clinical performance. However, this approach is restricted by issues such as material shrinkage and part warpage when HDPE is processed through the FDM technology. This review paper presents an overview of FDM of HDPE to produce facial reconstruction implants.

Fascial turnover flap - an effective method to resolve cartilage exposure after autologous microtia reconstruction

Introduction. Microtia presents a congenital ear deformity ranging from a minor and barely visible defect to a complete absence of the ear. Currently, there are three options for ear reconstruction: autologous costal cartilage, silicon prothesis, and prosthetic ear. Ear reconstruction with autologous costal cartilage is usually performed in two stages. During the first stage, the cartilaginous framework is fabricated and placed under the skin, in the anatomical position of the ear. In the second stage, the elevation of the frame is performed. During these procedures, complications such as vascular compromise of the skin envelope can occur. Cartilage exposure can lead to its resorption and distortion, leading to an unsatisfactory anatomical result, and this should be resolved as soon as possible. Cartilage exposure at the convex part of the frame is especially problematic. The goal of this paper is to show that fascial turnover flap is a safe method to deal with cartilage exposure as a complication. Outlines of cases. We present two patients with anotia and hemifacial microsomia. Both underwent autologous cartilage microtia repair. In both patients, the cartilage exposure at the convex part of the ear was revealed as a complication. Fascial turnover flap has been used to resolve this complication in both patients. Conclusion. Fascial turnover flap is a safe method to deal with cartilage exposure after microtia reconstruction with autologous cartilage.

The Multiple V-Y Advancement Modification for the Surgical Correction of Cryptotia.

Cryptotia is a rare congenital auricular deformity among Caucasians but more common in Asians. Various operative techniques have been described, such as skin graft, V-Y plasty, Z plasty, and islands skin flap. Among those techniques, V-Y plasty has many advantages and is indicated for severe cases. However, several problems remain when this method is adopted, such as conspicuous scars and lowered hairline. To overcome these problems, the authors have developed a new technique, multiple V-Y advancement modification, which stitches the skin flaps together to a tight, discrete central focal point. This technique has the advantage of hiding scars behind the earlobe, providing enough skin for the deformed areas, minimizing the condition of the hairline being lowered and auriculocephalic sulcus depth.

Outcomes of Open Rhinoplasty for Unilateral Cleft Patients using Photogrammetric Analysis - An Evaluative Study.

Secondary cleft rhinoplasty is a challenge due to the complex anatomy of the nose, with structural deformity and difficulty in surgical management. This study aimed to evaluate the effect of an anatomical-based approach on enhancing tip and alar symmetry in secondary unilateral cleft rhinoplasty using photogrammetric evaluation. The study was conducted on 57 adult patients seeking rhinoplasty after primary repair of congenital unilateral cleft lip deformity. All patients were operated upon using an external open rhinoplasty approach using an anatomical-based surgical technique. The cases were periodically followed up at three, six, 12 and 18 months for both aesthetic and functional outcomes with photogrammetric analysis of facial profile using the software Mirror Suite programme to compare before and after the surgical procedure. The photogrammetric analysis showed a significant improvement of facial angles (P = 0.05). The nasofrontal angle changed from a median of 146° to 132.5°, nasolabial angle of 73° to 95°, nasofacial angle of 21.5° to 32° and nasomental angle of 105° to 130°. The rotation angle of the nasal tip showed a significant cephalic rotation with a mean increase of the tip elongation of 1.8 cm achieved per lateralised millimetre. Secondary rhinoplasty in unilateral cleft deformities needs accurate evaluation of the anatomical and pathological abnormalities. Open approach is preferred with using costal cartilage graft allowing adequate columellar lengthening, maxillary enhancement and alar repositioning which leads to optimise the definition, projection and cephalic rotation with better stabilisation and symmetry of the nasal tip.

Aneurisma de septo interatrial associado a forame oval patente em cão - relato de caso

ABSTRACT Atrial septal aneurysm (ASA) is a rare congenital deformity of variable clinical relevance, often reported in association with patent foramen ovale (PFO). Transthoracic Doppler echocardiography (TTE) is the first choice for diagnosis, but complementary techniques, such as microbubble contrast, should be used. Despite its importance, in Veterinary Medicine, there is little information related to the subject, and the present study is the second report of this condition in dogs. The objective was to report a case of ASA type IV LR associated with PFO in a Shar Pei bitch, diagnosed by a combined approach of transthoracic echocardiography backed by agitated saline solution (microbubbles). During clinical care, the owners reported episodes of seizures as their main complaint. Echocardiographic examination revealed a type 4 LR atrial septal aneurysm and left ventricular systolic dysfunction. The use of microbubble contrast showed right-to-left shunt, confirming PFO. The recommended treatment was medication. It was concluded that the rarity of ASA in dogs may be due to incomplete diagnoses and the transthoracic echocardiographic examination allows its analysis and classification. Furthermore, ASA can be found in animals with or without evidence of heart disease and it should be investigated in patients with neurological alterations.

EVALUATION OF EARLY TREATMENT OF IDIOPATHIC CLUBFOOT USING THE PONSETI METHOD.

To evaluate the clinical outcome of clubfoot treatment using the Ponseti method under local conditions. The clinical evaluation will include a descriptive analysis of the sample, as well as radiographic evaluation and family satisfaction with the treatment. In total, 46% of the patients had good results and no family was dissatisfied with the treatment results. No statistically relevant relationships were found between the studied variables. The results are good and generally similar to those in the literature. Our epidemiological data generally agree with those reported by other authors. Level of Evidence IV, Case Series.

INFLUENCE OF BAD HABITS ON THE DEVELOPMENT OF ACQUIRED DEFORMATIONS IN THE MAXILLOFACIAL AREA.

The aim: Identifying the relationship between the presence of oral habit and acquired maxillomandibular anomalies, influence of oral habits on the skeleton and muscular system formation in children. Materials and methods: We conducted clinical, radiological methods of examination of 60 patients aged 9-12 with acquired maxillomandibular anomalies, 15 persons aged 9-12 years without maxillomandibular anomalies and acquired deformities (norm group) and 15 persons aged 9-12 years with hereditary syndromes, which are combined with bone deformities in the maxillofacial area (comparison group). Results: Clinical examination showed that oral habits were manifested in 98.3% of patients. The results of clinical and radiological examination, analysis of cephalometric parameters and data on the thickness of the masticatory muscles on symmetrical areas of the face confirm the relationship between chronic oral habits and formation of acquired maxillomandibular anomalies; confirm the presence of acquired rather than congenital deformity of the facial skeleton, which is associated with changes in the thickness of the masticatory muscles on the part of the deformation та compensatory muscle hypertrophy on the opposite side. Conclusions: The oral habit should be considered as one of the triggers in the development of acquired deformities of the maxillofacial area.

Updated Evidence in Management of Cleft Lip and Palate: Simple Review Article

The most common oro-facial congenital deformity reported in live newborns is a cleft of the lip, palate, or both. The objective of this study was to the updates in management, and outcomes of cases of cleft lip and/or palate. PubMed and EBSCO Information Services will be chosen as the search databases for the publications used within the study. Topics concerning the updates in management, and outcomes of cases of cleft lip and/or palate, published in English around

Підвищення якості діагностики зубощелепних деформацій на фоні хронічних звичок

The aim of the study. Improving the effectiveness of the diagnosis of maxillomandibular anomalies among the patients with pathological occlusion, existing bad habits is relevant due to the spread of social stress among young people and the search for its compensation through the development of bad habits. Research methods. We conducted clinical and radiological methods of examination of 60 patients aged 15–17 with acquired maxillomandibular anomalies, deformities, and 15 people in the comparison group. We studied the data of computer tomograms, performed stereotopometric analysis (threedimensional cephalometry), determination of the thickness of the masticatory muscles in symmetrical areas of the face. Patients underwent a secret questionnaire to identify stressors that affected the body, studied the relationship between the presence of stress and the appearance of changes in cephalometric parameters. Scientific novelty. Clinical studies and survey results have shown that 95 % of patients surveyed have bad habits that are associated with chronic social stress. The results of examination of cephalometric analysis and photoprotocol confirm the expressed disproportions of one of the jaws, where there is a oral habit; confirm the presence of acquired rather than congenital deformity of the facial skeleton, which is associated with changes in the thickness of the masticatory muscles on the side of the deformation. Conclusions. Our research has shown that bad habits progress in the presence of chronic social stress, which according to the survey results in 95% of patients. Distance learning is the most important stress factor in most patients surveyed.3D cephalometric analysis should be included in the mandatory methods for the diagnosis of acquired deformities of the maxillofacial area. Clinical and radiological research methods help the orthodontist to identify a whole range of interrelated etiological factors in the development of dental anomalies and acquired deformities of the maxillofacial area and make a correct plan of complex treatment. Key words: Stress, Sleeping Habits, Tongue Habits, Cephalometry, Face, Orthodontic, Deformities.

The neurophysiology aspect of congenital craniofacial deformities in children

Congenital craniofacial deformities in children are conditions with varying degrees of severity between minor and severe, they can be present at birth, but they can also be detected during the child's development. Material and methods. In the period 2014-2021, 57 children (29 boys and 28 girls), average age 9,1 ± 2,4 months, with craniofacial deformities from different medical centers in the Republic of Moldova were examined polysystemically. In this sense, we evaluated the state of the masseter, temporal and tongue muscles by electromyography with surface electrodes to determine the quality of their muscle activity. Recordings of the bioelectrical activity of muscle activity during exercise were performed using a Nihon Kohden portable electromyograph (Japan). Results. The balance dysfunction of the neuromuscular system in these children, as a neuro-physiological sign of pathological muscular weakness in the sucking reflex activity, is highlighted in 87.7% of cases by a marked asymmetry (p<0.001) of the tongue and masseter muscles activity and, respectively less highlighted (p<0.05) of the anterior temporal. Discussion. Thus, the EMG pattern evaluation highlights a decrease in the average amplitude of the action potentials (mV) mainly for the tongue, mm. masseters and temporalis on the left side, associated with an increase in the potential (ms) average duration from both the affected and the contralateral muscles, thus reflecting the reduction in their contraction capacity and the quality decrease in the act of sucking and mastication, predominantly on the left, in the child with congenital craniofacial deformities and disorders of the sucking reflex in infants. Conclusions. The neurophysiological examination highlights various forms of muscle function abnormalities in children with craniofacial deformities, which require multifunctional and multidisciplinary recovery.

CONGENITAL SWAN NECK DEFORMITY: A CASE REPORT AND REVIEW OF LITERATURE

Many theories have been suggested for the etiology of congenital swan neck deformity. The one main theory is that there is a lack of anatomical balance of the extrinsic and intrinsic muscles of the finger that is affected. Also, due to the imbalance between the flexors and extensors, flexion at the proximal interphalangeal joint results. As the patient gets older, there is increased lag in the extensors leading to worse flexion deformity, and this is mainly an aesthetic rather than a purely functional problem.A seven-month-old female infant presented with a hand deformity (congenital swan neck deformity on the fifth finger) that started appearing spontaneously and insidiouslywhen the infant was six months old. Operations for this type of deformity can range from skin plasties, artholysis, tenotomies, tendon transfers, and osteotomies to arthrodesis.Postoperative care consists of a splint, in which the duration in which it is kept is based on the technique used.

The use of the apparatus of an intelligent system with biofeedback in the evaluation of preoperative preparation of a patient with type I diastematomyelia: clinical case

BACKGROUND: Diastematomyelia is a rare congenital anomaly of the spinal cord, characterized by its cleavage in the spinal canal, which can be combined with spinal deformity. When correcting scoliotic deformity, patients with this anomaly have a high risk of developing neurological disorders due to its fixation. Therefore, its preliminary mobilization surgically is necessary. In the upcoming corrective surgery, an important role is also played by preoperative halo-traction training in combination with therapeutic physical culture.
 CLINICAL CASE DESCRIPTION: A clinical case of the use of the Tergumed 3D intelligent biofeedback system in assessing the effectiveness of preoperative halo-gravity traction in combination with mobilizing therapeutic physical culture in a patient with complex spinal deformity against the background of congenital malformation (type I diastematomyelia) to prepare for surgical correction is presented.
 CONCLUSION: The results of this study suggest that the combination of physical therapy and halo-traction can be effectively used for preoperative preparation of patients with rigid scoliotic deformities and spinal anomalies. It help analyze preoperative preparation in patients with congenital spinal deformities.

Picture Cards Versus Physical Examination: A Proof-of-Concept Study to Improve the SOSAS Survey Tool

IntroductionThe Surgeons OverSeas Assessment of Surgical Needs (SOSAS) survey tool is used to determine the unmet surgical needs in the community and has been validated in several countries. A major weakness is the absence of an objective assessment to verify patient-reported surgically treatable conditions. The goal of this study was to determine whether a picture portfolio, a tool previously shown to improve parental recognition of their child's congenital deformity, could improve the accuracy of the SOSAS tool by how it compares with physical examination. This study focused on children as many surgical conditions in them require prompt treatment but are often not promptly diagnosed. MethodsWe conducted a descriptive cross-sectional community-based study to determine the prevalence of congenital and acquired surgical conditions among children and adults in a mixed rural-urban area of Lagos, Southwest Nigeria. The picture portfolio was administered only to children and the surgical conditions to be assessed were predetermined using an e-Delphi process among pediatric surgeons. The modified The Surgeons OverSeas Assessment of Surgical Needs–Nigeria Survey Tool (SOSAS-NST) was administered to household members to collect other relevant data. Data were analyzed using the REDCap analytic tool. ResultsEight hundred and fifty-six households were surveyed. There were 1984 adults (49.5%) and 2027 children (50.5%). Thirty-six children met the predetermined criteria for the picture portfolio–hydrocephalus (n = 1); lymphatic malformation (n = 1); umbilical hernia (n = 14); Hydrocele (n = 5); inguinal hernia (n = 10) and undescended testes (n = 5). The picture portfolio predicted all correctly except a case of undescended testis that was mistaken for a hernia. The sensitivity of the picture portfolio was therefore 35/36 or 97.2%. ConclusionsThe SOSAS-NST has improved on the original SOSAS tool and within the limits of the small numbers, the picture portfolio has a high accuracy in predicting diagnosis in children in lieu of physical examination.

The efficacy of “TiRobot”orthopaedic robot-assisted VS conventional fluoroscopic percutaneous screw fixation of the sacroiliac joint

PurposeThis study is to compare the precision and safety of the orthopaedic robot with conventional fluoroscopy for assisted percutaneous sacroiliac joint screw implantation.MethodsRetrospective analysis was performed on the clinical data of 57 patients with unstable posterior pelvic ring injuries who were admitted and met the criteria between January 2017 and January 2022. All of these patients underwent percutaneous sacroiliac joint screw implantation, and their clinical data were split into two groups based on the surgical technique: a RA group (robot-assisted implantation, 30 patients, 54 screws) and a CF group (conventional fluoroscopic freehand implantation, 27 patients, 42 screws). There were 96 screws placed in total. The durations of the two groups’ operations, fluoroscopy examinations, fluoroscopy doses, total number of fluoroscopies, and intra-operative guide pin applications were noted and compared. On post-operative CT scans, the placement of each screw was assessed using the Gertzbein-Robbins classification. Finally, imaging Matta criteria were used to assess the sacroiliac joint fracture reduction. The Majeed functional score was used to assess clinical function.ResultsBoth groups successfully completed 57 procedures in total. In both groups, there were no consequences from vascular injury, wound infection, or urinary tract infection. Additionally, there were no complications from robotic-induced nerve injury, operating time, fluoroscopic dose, and the frequency of fluoroscopic; the number of percutaneous punctures in the RA group was lower than that of the CF group.There were statistically significant differences between the aforementioned data (P < 0.05). The modified Matta evaluated the effectiveness of fracture reduction. In the RA group, there was no statistically significant difference between the CF group (P > 0.05). According to the modified Gertzbein-Robbins classification criteria, the 54 screws implanted in the RA group were classified as follows: class A (45), class B (5), class C (4), and class D (0); the accuracy rate of the implants was 92.59%. Forty-two screws implanted in the CF group, 30 screws were defined class A, class B (3), class C (7), and class D (2). The accuracy rate of the implants was 78.57%(χ2 = 3.967, P < 0.05). There was a statistically significant difference between the two groups. The Majeed score 30 patients in RA group, one month post-operation, 16 considered exceptional, eight decent, six moderate, and zero bad. Post-operation more than six months,25 recorded exceptional, five decent. By the time,27 patients in CF group,12 exceptional grade, eight decent, six moderate, and one bad,one month post-operation. Post-operation more than six months,22 recorded exceptional, five decent.Both group (P > 0.05).Conclusion“TiRobot” robot-assisted screw implant treatment for unstable posterior pelvic ring injury has a greater success rate than traditional surgery as compared to conventional percutaneous screw implant. It is a precise, secure, and minimally invasive surgical technique that can also be applied to severe pelvic injuries even congenital sacral deformities.

Silikat Katkılı Sentetik Fleksible Biyomalzemenin Mekanik Özelliklerinin İncelenmesi

Biomaterials play an active role in tissue regeneration and are widely used in the treatment of tissue transplantation applications for the repair of damaged hard tissue, bone cancer, bone loss due to skeletal trauma and infection, bone fractures and congenital deformities of the facial and skull bones. Since autografts and allografts have many disadvantages, there is a need for synthetic bone grafts and biomaterials. Many bioceramic materials such as beta-tricalcium phosphate (beta-TCP) and calcium sulfate are widely used in bone formation. Since beta-TCP-based bone grafts are used in the form of granules, silicate reinforced flexible strips are used in orthopedic surgery, oral and maxillofacial surgery. The aim of this study is to examine the mechanical properties of silicate-doped flexible biomaterials, taking into account their biocompatibility and their positive effects on tissue regeneration. In order to achieve the stated purpose, the methods planned to be followed, tensile tests will be applied for the mechanical properties of the scanning electron microscope (SEM) image for its morphology. In this study, it was found that silicate-doped flexible biomaterials have a homogeneous and porous structure. In addition, the obtained mechanical test results and the functionality of the silicate-doped flexible biomaterial during bone regeneration according to the ISO (International Organization for Standardization) 5833 and ASTM (American Society for Testing and Materials) D638 standard have been demonstrated.

Classifications of congenital hand deformities: View through the prism of time

This medico-historical analysis focused on the formation of present classifications of congenital hand deformities. Its implementation became possible thanks to the study of 163 literary sources, the search of which was carried out in the scientometric databases of Scopus, PubMed, Google Scholar, and Web of Science. The depth of the exploration has exceeded 180 years (from 1829 to 2017). Those dates make obvious that the initial steps in the systematization of regarded vices were taken in 18th19th centuries. Publications at that time became the foundation that pushed many scientists to develop the wide range of descriptive classifications. The complexity of their practical use required the creation of fundamentally different concepts of dividing anomalies. It became possible due to the discovery of the embryogenesis of the hand. The result of long-term studies was the acceptance of the actual method of the systematization of upper limb defects by IFSSH in 2014. The comprehension of stages, preceding its formation, is quite important for the medical community and facilitates the assessment of individual patients features.

Free flaps to replace extensive and deep limb defects in children

BACKGROUND: Extensive and deep limb defects remain a difficult problem of reconstructive surgery in children. Free microsurgical flaps are used to resolve this problem. Free flaps can be complex in composition and include muscles and bone parts, which allow replacing large and multicomponent limb defects. The technique is used in patients with posttraumatic deformities, burns, acquired limb deformities, and congenital deformities of the extremities.&#x0D; AIM: To retrospectively analyze free flaps in children for the replacement of limb defects.&#x0D; MATERIALS AND METHODS: This single-center retrospective study analyzed 120 cases of microsurgical autotransplantation of free flaps to replace defects of the upper and lower extremities in children. The patients were children aged 117 years who had injuries and burns, acquired limb deformities, and congenital limb deformities.&#x0D; RESULTS: The average age of the patients was 9.5 years, and 72% of the patients were boys. Moreover, 95% of the children had posttraumatic deformities, burns, and acquired pathologies. Free latissimus dorsi flaps were used in 70% of the patients. The recipient area was the upper limb in 53% of the cases. The survival rate of free flaps was 96%. The general surgical complications were inflammation, pneumothorax, deformities, and specific vascular thrombosis.&#x0D; CONCLUSIONS: Replacement of extensive limb defects with free flaps remains a practical method in children.

CD8+ T Cells Trigger Auricular Dermatitis and Blepharitis in Mice after Zika Virus Infection in the Absence of CD4+ T Cells

Zika virus (ZIKV) became a public health concern when it re-emerged in 2015 owing to its ability to cause congenital deformities in the fetus and neurological complications in adults. Despite extensive data on protection, the interplay of protective and pathogenic adaptive immune responses toward ZIKV infection remains poorly understood. In this study, using a T-cell‒deficient mouse model that retains persistent ZIKV viral titers in the blood and organs, we show that the adoptive transfer of CD8+ T cells led to a significant reduction in viral load. This mouse model reveals that ZIKV can induce grossly visible auricular dermatitis and blepharitis, mediated by ZIKV-specific CD8+ T cells. Single-cell RNA sequencing of these causative CD8+ T cells from the ears shows an overactivated and elevated cytotoxic signature in mice with severe symptoms. Our results strongly suggest a role for CD8+ T-cell‒associated pathologies after ZIKV infection in CD4+ T-cell‒immunodeficient patients.

Rodent Model for Orthotopic Implantation of Engineered Liver Devices.

This study presents a novel surgical model developed to provide hematological support for implanted cellularized devices augmenting or replacing liver tissue function. Advances in bioengineering provide tools and materials to create living tissue replacements designed to restore that lost to disease, trauma, or congenital deformity. Such substitutes are often assembled and matured in vitro and need an immediate blood supply upon implantation, necessitating the development of supporting protocols. Animal translational models are required for continued development of engineered structures before clinical implementation, with rodent models often playing an essential early role. Our long-term goal has been generation of living tissue to provide liver function, utilizing advances in additive manufacturing technology to create 3D structures with intrinsic micron to millimeter scale channels modeled on natural vasculature. The surgical protocol developed enables testing various design iterations in vivo by anastomosis to the host rat vasculature. Lobation of rodent liver facilitates partial hepatectomy and repurposing the remaining vasculature to support implanted engineered tissue. Removal of the left lateral lobe exposes the underlying hepatic vasculature and can create space for a device. A shunt is created from the left portal vein to the left hepatic vein by cannulating each with separate silicone tubing. The device is then integrated into the shunt by connecting its inflow and outflow ports to the tubing and reestablishing blood flow. Sustained anticoagulation is maintained with an implanted osmotic pump. In our studies, animals were freely mobile after implantation; devices remained patent while maintaining blood flow through their millifluidic channels. This vascular anastomosis model has been greatly refined during the process of performing over 200 implantation procedures. We anticipate that the model described herein will find utility in developing preclinical translational protocols for evaluation of engineered liver tissue. Impact statement Tissue and organ transplantation are often the best clinically effective treatments for a variety of human ailments. However, the availability of suitable donor organs remains a critical problem. Advances in biotechnology hold potential in alleviating shortages, yet further work is required to surgically integrate large engineered tissues to host vasculature. Improved animal models such as the one described are valuable tools to support continued development and evaluation of novel therapies.