Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities

The sucker-like end-to-side arterial anastomosis for free flap in extremities reconstruction: a retrospective study of 78 cases

“…The parachute ETS anastomosis technique is widely employed by cardiovascular and vascular surgeons for various types of bypass surgery. In prior studies by Naoya Watanabe et al, the microscopic parachute ETS (MPETS) anastomosis technique was utilized to address the diameter discrepancies in vessels [ 17 , 21 ]. According to their account, MPETS shares similarities with our sucker-like anastomosis technique, involving the trimming of stomas in both donor and recipient vessels in order to mitigate the drawbacks arising from size mismatch.…”

“…According to their account, MPETS shares similarities with our sucker-like anastomosis technique, involving the trimming of stomas in both donor and recipient vessels in order to mitigate the drawbacks arising from size mismatch. This methodology has demonstrated promising therapeutic outcomes, with the majority of flaps exhibiting viability when employing the MPETS technique for both arterial and venous anastomosis [ 17 , 21 ]. In comparison with the MPETS technique, the sucker-like anastomosis technique investigated in the present study has a number of distinct advantages: (1) While MPETS widens the stoma of the flap artery, the obtuse angle on both sides remains inadequately trimmed, potentially leading to an uneven incision.…”

A simple free flap strategy using end-to-side anastomosis to the main vessels in injured extremity

“…Because the surgeon can select the accompanying vein as the recipient vein without seeking another suitable vein when using the venous ETS technique, we believe that the AV-ETS strategy will make soft tissue reconstruction less invasive. 35 , 38 …”

“… 16 , 22 We have previously reported the MPETS technique as a simple and reliable method for ETS anastomosis. 25 , 26 , 38 The MPETS method has many advantages, including a simple slit-shaped vesselotomy, large window to avoid stenosis, and reliable sutures using the parachute technique in the heel of the flap vessels where blood leakage is likely to occur. The MPETS technique can be applied to large and small vessels, as well as arteries and veins by performing the procedure under a microscope.…”