title: Modified back wall first artery anastomosis technique in living donor liver transplantation.
abstract: OBJECTIVE
  Back wall technique is usually used for hepatic artery anastomosis in living donor liver-transplantation. In this technique, two stitches are placed in the two corners of the artery wall initially and the microclamp on the artery is rotated to place the sutures to the back wall first. In some cases, the microclamp cannot be rotated because of insufficient length of the graft or recipient artery. If this occurs, it may be difficult to rotate the artery to perform the back wall artery anastomosis technique. In these cases, the difficulty of performing the anastomosis can cause intimal tears. Thus, we prefer a modified technique for artery anastomosis in such situations.
  
  
  METHODS
  In this modified technique, two stitches are placed in the middle of the posterior wall and middle of the anterior wall initially. The artery is twisted 90° to the right side and to the left side respectively, instead of one 180° rotation, to place the back wall stitches.
  
  
  CONCLUSIONS
  In this modified technique, reversing the microclamp is eliminated that can cause intimal damage. Therefore, it may be superior to the conventional method in terms of reducing the difficulty of performing anastomosis and intimal damage to the vessels.
authors: Department of General Surgery, Solid Organ Transplantation, Gaziantep University Medical Faculty, Unit, Gaziantep, Turkey.
authors: Sacit
authors: S
authors: Coban
authors: Department of General Surgery, Solid Organ Transplantation, Gaziantep University Medical Faculty, Unit, Gaziantep, Turkey. Electronic address: fahrettinyildiz@hotmail.com.
authors: Fahrettin
authors: F
authors: Yildiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D055815:Young Adult
keywords: back wall technique; liver transplantation