Review of facilitated approaches to vascular anastomosis surgery.
BACKGROUND
There is an increasing demand for an easier, quicker, less damaging, but reliable procedure to create a vascular anastomosis. This demand is not new but is revitalized by the movement of vascular procedures in various specialties, including cardiac surgery, toward minimally invasive procedures. This article reviews the most important representatives of devices or methods that have been developed in the last two centuries.


METHODS
A thorough literature search was performed. The outcome is presented and discussed in four parts: (1) stapling and clipping devices, (2) coupling devices, (3) glues, and (4) laser welding.


RESULTS
Stapling devices have not become the standard fashion to create an anastomosis because they are too complicated to use. In selected cases clips have potential in vascular surgery. There is a ring-pin coupling system available that is easy to use and especially suitable for creating an end-to-end anastomosis. The ideal glue is yet to be developed, and the currently available laser welding techniques have to become refined.


CONCLUSIONS
It is anticipated that the future lies in hybrid techniques that combine sutures or clips with glues or laser-welding techniques.
Werker
P M
PM
Department of Plastic, Reconstructive and Hand Surgery, University Hospital Utrecht, the Netherlands. p.m.n.werker@chir.azu.nl
Kon
M
M
D000714:Anastomosis, Surgical / Q000266:history / Q000295:instrumentation / Q000379:methods*; D049673:History, 20th Century; D006801:Humans; D053685:Laser Therapy / Q000266:history / Q000379:methods; D013528:Surgical Staplers / Q000266:history; D014014:Tissue Adhesives / Q000266:history; D014656:Vascular Surgical Procedures / Q000266:history / Q000295:instrumentation / Q000379:methods*
D014014:Tissue Adhesives