title: Tissue reconstruction with nonpenetrating arcuate-legged clips. Potential endoscopic applications.
abstract: A new system for tissue approximation consisting of a nonpenetrating arcuate-legged clip applied to everted tissue edges to form an elastomeric flanged joint is described. The flanged joint has unusual physical and morphologic properties. Novel systems for tissue eversion, clip application and clip removal have been tested at the micro scale in blood vessels and the rat vas deferens (vasovasostomy). Human applications have been successful (cerebrovascular reconstruction, free-flap transfer, skin grafting, A-V access). The system is biologically and technically equivalent to or superior to the needle-and-suture technique. Avoidance of intimal or mucosal penetration or intraluminal foreign body is associated with prompt wound healing and the reconstitution of tubular integrity. The system is readily adaptable for endoscopic surgical reconstructions, providing the surgeon with enhanced reconstructive abilities.
authors.affiliation: Division of Neurosurgery, Loma Linda University Medical Center, CA 92350.
authors.forename: W M
authors.initials: WM
authors.lastname: Kirsch
authors.forename: Y H
authors.initials: YH
authors.lastname: Zhu
authors.forename: D
authors.initials: D
authors.lastname: Gaskill
authors.forename: S
authors.initials: S
authors.lastname: Stewart
authors.forename: R A
authors.initials: RA
authors.lastname: Hardesty
authors.forename: T L
authors.initials: TL
authors.lastname: Lyons
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D005260:Female; D005263:Femoral Artery / Q000033:anatomy & histology / Q000601:surgery; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D014649:Vas Deferens / Q000033:anatomy & histology; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D014669:Vasovasostomy / Q000295:instrumentation* / Q000379:methods*