Microsuture-tying forceps with attached scissors for bypass surgery.
BACKGROUND
Bypass surgery requires the shortest temporary occlusion time of a recipient artery during anastomosis. For this purpose, we have devised a microforceps with attached scissors that makes it possible to perform the multiple steps involved in anastomosis without exchanging instruments. This microforceps avoids having to exchange instruments twice in one suturing, such as that between a microsuture-tying forceps or a microneedle holder and microscissors in conventional methods.


METHODS
The instrument is made of stainless steel and is 15.5 cm long. Using this microforceps with scissors, we can suture, tie, and cut a ligature fluently for consecutive sutures without exchanging instruments. The mean time during one suturing was compared between two patient groups treated by conventional method and with use of this instrument.


RESULTS
This instrument was used for 34 patients with ischemic cerebrovascular disease (including three who needed deep-site anastomoses) and allowed us to perform superficial temporal artery-middle cerebral artery (STA-MCA) anastomoses uneventfully. This instrument saved 15.2 s in the mean time during one suturing.


CONCLUSIONS
Although it is of paramount importance to practice tying sutures well, this new instrument removes the need to exchange conventional instruments, and we believe it will save time and, therefore, decrease complications during bypass surgery.
Department of Neurosurgery, Fuji Brain Institute & Hospital, Fujinomiya City, Shizuoka Prefecture, Japan.
Michihiro
M
Kohno
Hiromu
H
Segawa
Hirofumi
H
Nakatomi
Keiji
K
Sano
Toyohisa
T
Akitaya
Toshiaki
T
Takahashi
D000714:Anastomosis, Surgical / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation; D013525:Surgical Instruments; D013537:Sutures; D014656:Vascular Surgical Procedures / Q000295:instrumentation*