Experimental Study Of A New Vascular Anastomosis Method

At present , microsurgery has developed widely in many fields, which include cardiovascular surgery, department of cerebral surgery, urinary surgery,department of gynaecology and obstetrics, vascellum lymphaticum, and so on. Microvascular anastomosis is crucial to microsurgery. The conventional microvascular anastomosis method is suturing, which usually utilizes microscope, also being named"gold standard"microvascular anastomosis method. However, the suturing anastomosis has some defects. For example, the procedure is time- consumed and it is technically difficult, especially for low-grade clinician to practically master the manipulation in short period; it leads to serious damage to vessel wall, especially to the intima; suture material exposes into the vessel lumen, which would cause thrombocyte gathering and thrombogenesis. We attempt to seek an ideal microvascular anastomosis method. To evaluate the feasibility and superiority of the vascular anastomosis with two-way bullet-shaped vascular staplers, two-way bullet-shaped vascular staplers developed by ourselves are used to anastomose carotid arteries of rabbits, and the results are compared with the conventional suturing anastomosis technique.Methods: We adopted 20 adult healthy rabbits, female or male, body weight 2.5~2.8kg. A comparative experimental study was performed in carotid arteries of the adult rabbits (caliber 2.0～3.0mm,average 2.4mm ). One side of carotid artery was anastomosed with new anastomosis mathed, the other side was end-end anastomosed with suturing. TA (time for anastomosis) was noted during the experiment .We executed the rabbits to make specimen and slice in the 7th and 14th postoperative day. The vessel speciments were harvested at the same time and were analyzed by light microscope. Time for anastomosis data was statisticated.Results: One rabbit was dead in the 1st postoperative day, the others (19 rabbits) were healthy. There was no incident of arteriospasm, thrombebolia, infect of anastomotic stomas. Anatomy confirmed that thrombogenesis of suturing arterial anastomosis was the cause of death. The survival rate is 95% and the vessal patency rate is 100%. TA of the microvascular anastomosis with TBVS is (12.0±2.4) min, is less than that with suturing, which is (16.0±2.7) min. The histological results indicate that the vessel wall healing of the anastomosis with TBVS is better than that with suturing. The endothelial cells regenerate earlier, and the intimae are smoother.Concluson: The microvascular anastomosis technique with TBVS was proved to be rapider and easier. It is also safe and reliable. This kind of microvascular anastomosis method is feasible and innovative.