Vessel Suture Research Articles

Technical considerations in the transplantation of the kidney to the dog's neck

Summary A technique for transplantation of the kidney to the dog's neck employing end-to-end suture of therenal vessels to the common carotid artery and external jugular vein with a cutaneous ureterostomy is described. The technical considerations necessary for the prevention of hydronephrosis and pyelonephritis have been emphasized.

THE USE OF A SIMPLIFIED STAPLING APPARATUS FOR AUTOMATIC SUTURING OF SMALL BLOOD VESSELS.

THE USE OF A SIMPLIFIED STAPLING APPARATUS FOR AUTOMATIC SUTURING OF SMALL BLOOD VESSELS.

Stapling device for end-to-side anastomosis of blood vessel.

An intensive study of mechanical suturing of blood vessels, and a new type of apparatus for end-to-end anastomosis1have previously been reported by the author. A number of animal experiments as well as clinical experiences have shown this apparatus to be useful in minimizing the time for vascular anastomosis and in guaranteeing the success of the anastomosis, particularly when applied to small arteries and veins. End-to-side anastomosis is an alternate type of technique in vascular surgery, and if this technique could be mechanically achieved simply and accurately, it might contribute a useful technique to the surgeon's armamentarium. Blakemore and Lord2reported a nonsuture method of end-to-side anastomosis using vitallium tube. Their technique, however, has been superseded by more refined suturing techniques and to our knowledge is no longer used. An apparatus for end-to-side anastomosis of blood vessels using tantalum staples is reported to have been produced in the

The wire suture of blood vessels; an experimental study.

Any one of such complications of bloodvessel suture as thrombosis, stricture, aneurysm formation, or dehiscence may lead to a fatal result. The threat of these complications is sufficient to warrant continuous search for new methods and improved techniques which will serve to avoid or to minimize them. In experiments described below, the use of stainless steel wire as a suture material for blood vessels has shown distinct promise in this regard. The materials ordinarily used for blood vessel suture have been (1) very fine surgical gut, (2) fine silk, and (3) fine cotton. The use of surgical gut having now been generally abandoned because of the intense reaction along the suture line, the use of fine nonabsorbable suture material has become an established principle in vascularsurgery. Silk has been used most widely. Cotton has also been employed satisfactorily. Stainless steel wire, however, appearsto possess certain advantages: its inert character, the

A new type of vesselsuturing apparatus.

A number of shortcomings have been found with manual vessel suture. They are arising mainly from these facts: Thrombosis is not infrequent at the anastomotic portion, owing to the irregularity and injury of intima at the anastomotic line; the method requires too much time; it is difficult to anastomose small-calibered vessels. The present paper deals with a new vessel-suture apparatus which is made to overcome these shortcomings of the manual method and to make the complicated vessel suture easy and accessible even for unspecialized surgeons. So far, the only paper on the mechanized vessel suture seems to be that of Androsov,1of the Soviet Union, of which I happened to learn in the course of my experimentation on this apparatus. The new apparatus is devised by my own idea, supported by my experimental evidence that if mechanical anastomosis is achieved with the vessel ends securely everted, injury of the

Mechanical and hand suture of blood vessels.

Mechanical and hand suture of blood vessels.

Cardiovascular needle holder for delicate suturing.

During the suturing of blood vessels with 00000 arterial silk on atraumatic needle, it became apparent, especially in deeper wounds, that the ordinary needle holder with the ring-type handle and lock, even when equipped with diamond jaws, was not entirely adequate. The ring-type needle holder on unlatching causes, in most instances, a small amount of movement of the needle while the latter is being released. This motion at times is enough to form small tears at the needle hole. It was noted that the 00000 arterial silk with a swedged-on needle pierced the blood vessels in coarctation, Blalock, Potts, and other cardiovascular procedures with very little force, and when the needle was held in the usual vascular thumb forceps it could easily be pushed through the vessel. The only difficulty was placing and holding the needle in proper position in the thumb forceps. With the premise that a thumb forceps-type

Method of blood vessel anastomosis by means of metal clips; an experimental study.

IN JOINING together the tubular structures of the body, surgical craftsmanship approaches art. Successful anastomosis is based upon knowledge of the tube's structure, blood supply, mode of healing, and, above all, the properties of its contents. The means at hand are the smallest consideration. The ideal vascular anastomosis represents a watertight junction sufficiently strong to resist lateral and longitudinal tension, whose inner surface offers neither mechanical nor biochemical inducement for thrombosis. The ultimate repair must not deform the lumen or hinder the growth of the vessel. In addition, the operation must be accomplished well within the safe time limit of occlusion for the area supplied by the vessel. By the turn of the century, techniques necessary to the attainment of this aim, such as triangulation of the vessel and intima-to-intima approximation by means of everting sutures, had been devised.* However, the exacting and sometimes exasperating nature of blood vessel suture

Simple one-stage method of hepatectomy in the dog.

THE METHOD to be described in this paper is an extension of that of Markowitz, Yater, and Burrows.1The introduction of silicone by our colleague, Jacques, and the availability at surgical supply houses of blood vessel suture ready for use, together with considerable experience over the past two decades, has prompted us to publish this method in its present form. The operation of hepatectomy in the dog is a difficult technical procedure. When badly done the operation results in hemorrhage and shock; any studies made have to be considered in the light of these complicating factors. When done well hepatectomy results in a preparation that is seemingly normal for at least 12 hours; the duration of survival and the postoperative behavior following this time depend upon such uncontrollable circumstances as prothrombin, bleeding, and the general viability of the animal that has been selected essentially at random. Although the liver

Blood vessel suture: Its use instead of the ligature in war surgery

Blood vessel suture: Its use instead of the ligature in war surgery

A new Needle for Suturing Tonsils

Among many methods of stopping hemorrhage after tonsillectomy the suture of the blood vessels is the surest way of regaining control.

SUCCESSFUL AUTOTRANSPLANTATION OF THE ADRENAL GLAND IN THE DOG

Autotransplantation of the adrenal gland in the rat and in the guinea pig has been reported by a number of investigators.¹However, it is generally accepted that such a graft undergoes partial necrosis which is followed by regeneration of cortical tissue only. A successful transplantation of the whole adrenal gland in small animals has not been described. Crowe and Wislocki²were among the first to attempt to transplant the adrenal in the dog. They observed that when fragments of the gland were placed in muscle only the cortical tissue survived. Such transplants were found to be functionless. Oldberg³and Blodinger and his co-workers⁴also were unable to obtain functioning autogenous grafts of the adrenal in the dog. Recently, however, Levy and Blalock⁵have reported transplantation of the kidney together with the adrenal to the neck (with reestablishment of the blood supply by suture of vessels)

Surgery, Its Principles and Practice. For Students and Practitioners.

The impression gained on a reading of this book is one of conservatism and practicability. Both bespeak the good judgment of the author, which is a comforting quality to the student or practitioner who depends on a text-book in any branch as a guide to study or for reference in his daily work. The principles of surgery are well and clearly laid down, and the diseases, accidents, operations and procedures which come largely within the skill and experience of the practitioner who does surgery are given a gratifying amount of attention, with concise but ample description. The more formidable surgical problems requiring the highest technic and knowledge are not neglected, but more details would perhaps be desired by many before attempting such work. Military surgery, the treatment of accidents and the suture of vessels and nerves are subjects detailed in a most satisfactory manner. In regard to fractures the author

An Early Case of Blood Vessel Suture at the Massachusetts General Hospital by the Late Dr. Maurice H. Richardson

An Early Case of Blood Vessel Suture at the Massachusetts General Hospital by the Late Dr. Maurice H. Richardson

Chirurgie Vasculaire Conservatrice. Technique — Indications Opératoires et Résultats.

This consists of a brief manual devoted chiefly to the technic of blood vessel suture. The greater part of the book is given to the application of the various types of arterial and venous suture to the practical problems of aneurysm and injuries. There are numerous line and wash drawings.

Replantation of Entire Limbs without Suture of Vessels

Replantation of Entire Limbs without Suture of Vessels

Concerning the Circular Suture of Vessels, Arteriovenous Anastomosis, and the Transplantation of Vessels

Concerning the Circular Suture of Vessels, Arteriovenous Anastomosis, and the Transplantation of Vessels

Intravascular foreign bodies

Experiments were performed by introducing sterilized (1) untreated, (2) oiled silk, and (3) human hair into arteries and veins and observing the results. Twelve common carotid arteries and twelve external jugular veins were employed. The number of silk strands varied from the smallest single strands used in blood vessel suture to twenty-four such strands. Where a number were used they were threaded into suitably large needles and were not twisted. Cambric needles were used.The experiments were performed by exposing the vessels of anesthetized dogs, transversely piercing the vessel with the needle as near the mid-line as possible, drawing the ligatures through and loosely tying the free ends together. Three weeks later specimens were taken and examined.In no instance was there occlusion of the lumen nor was there any evidence to indicate that the vessels would have subsequently become occluded through thrombus formation. In general the ligatures were found dividing the lumen and coated with a substance clo...

The Ideal Operation for Arterial Aneurysm; A Contribution to the Circular Suture of Vessels in Man

The Ideal Operation for Arterial Aneurysm; A Contribution to the Circular Suture of Vessels in Man

Human Hair Used for Sutures Long Ago

<h3>To the Editor:</h3> —I have been much interested in reading the article by Drs. Guthrie on the "Suture of Blood Vessels with Human Hair," inThe Journal, Jan. 29, 1910. I have had no experience with suture of blood vessels, but as a suture material for places requiring very delicate threads, especially the face, mucous membrane of the lips, and the conjunctiva, I have used human hair repeatedly—probably a hundred times or more from 1880, when I first began practice, onward, and always with excellent results; though not much sterilizing of sutures was done in the early days. Wounds so sutured did not suppurate, and the resulting scar was reduced to a minimum. The hair was just plucked as wanted from the head of any woman convenient, passed through a weak phenol solution, or more frequently not even that, and used at once. I never saw a bad result. I