title: The drop-down technique as an optimal technique for back-wall end-to-side anastomosis.
abstract: An advantage of end-to-side anastomosis is that thrombogenesis in the anastomotic part is less likely than with end-to-end anastomosis. Conversely, the operative procedure for end-to-side anastomosis is more complicated than that of end-to-end anastomosis. We usually perform a modified back-wall technique in which the outflow vessel is dropped over the inflow vessel. We performed end-to-side anastomoses using the single-knot, back-wall, and drop-down techniques and compared the time required. In addition, the authors tried to perform microvascular anastomosis in 15 clinical cases using the drop-down technique. We were able to perform anastomoses quickly using the drop-down, back-wall, and single-knot techniques. The drop-down technique was possible in 12 cases of venous anastomosis in 15 head and neck reconstruction cases. Using this method, we can perform a continuous suture of the posterior wall easily and quickly. The drop-down technique can simplify continuous suturing of posterior wall in the same way as skin suturing.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo; and †Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama, Okayama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Onoda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
authors.forename: Aya
authors.initials: A
authors.lastname: Goto
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D002645:Chickens; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D008955:Models, Cardiovascular; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D013927:Thrombosis / Q000517:prevention & control*