title: Bipolar anastomosis technique with removable instruments: an easy, fast, and reliable technique for vascular anastomosis.
abstract: The interrupted suture technique is most commonly used for microsurgical vascular anastomosis. For several reasons (e.g., exposure of suture material to blood, time needed), many attempts have been made to find other solutions. This article describes a new means of performing a microsurgical vascular anastomosis. The aim of this study was to show the feasibility and possible advantages of this new technique. The basic components at work here are a modified cuff and electrically generated heat used to unite the vessel walls. In this way, both endothelial layers are adapted without manipulating the inside of the vessel or leaving behind foreign matter. Various energy/coagulation time settings were used to perform arterial anastomoses (n = 42) in an isogeneic abdominal aorta interposition model in the rat. The quality of anastomosis was evaluated at days 1, 10, 21, and 120. Immediately after the welding process all anastomoses (n = 42) were patent. No stenosis was found at any observation time. Anastomosis time ranged from 3 to 18 minutes (average, 11 minutes). This new technique permits a vascular anastomosis to be performed easily and reliably with a high patency rate. With this technique, the authors are convinced that a skilled surgeon can create a high-quality anastomosis in a fraction of the time needed to sew an anastomosis.
authors.affiliation: Department of Trauma Surgery, Innsbruck University Hospital, Austria. heinrich.schubert@uibk.ac.at
authors.forename: Heinrich M
authors.initials: HM
authors.lastname: Schubert
authors.forename: Matthias
authors.initials: M
authors.lastname: Hohlrieder
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Jeske
authors.forename: Peter
authors.initials: P
authors.lastname: Obrist
authors.forename: Patrizia L
authors.initials: PL
authors.lastname: Moser
authors.forename: Winfried
authors.initials: W
authors.lastname: Mayr
authors.forename: Guenther
authors.initials: G
authors.lastname: Klima
authors.forename: Christian
authors.initials: C
authors.lastname: Kolbitsch
authors.forename: Raimund
authors.initials: R
authors.lastname: Margreiter
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D015203:Reproducibility of Results; D013552:Swine; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods*