Venous coupler for free-flap anastomosis: outcomes of 1,000 cases.
Since the advent of microvascular free tissue transfer, adjunctive surgical techniques have become sought as a means to improving overall surgical time and outcomes in oncological surgery. Anastomotic devices have provided one such avenue, with staples and coupling devices suggested as an alternative to traditional suturing. We describe our experience with two such devices, automatic staples and the anastomotic ring coupler, in 1,000 cases of free tissue transfer. In 1,400 anastomoses, there was a significant reduction in anastomotic time from suturing (22 minutes) with the use of staples (15 minutes) or the ring coupler (4 minutes), p<0.01. This was without any increase in complication rates. These findings support the use of these devices and suggest an increasing role for modern devices in microvascular surgery.
Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Grattan St, Parkville, Victoria, Australia. warrenrozen@hotmail.com
Warren M
WM
Rozen
Iain S
IS
Whitaker
Rafael
R
Acosta
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods; D001943:Breast Neoplasms / Q000601:surgery; D015331:Cohort Studies; D005121:Extremities / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply; D013525:Surgical Instruments; D013537:Sutures; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods