Experimental Devices Versus Hand-Sewn Anastomosis of the Aorta: A Systematic Review and Meta-Analysis

Manolesou, Danae; Georgiopoulos, G; Lazaris, Andreas M.; Schizas, Dimitrios; Stamatelopoulos, Kimon; Khir, Ashraf W.; Liakakos, Theodoros; Papaioannou, Theodore G.

doi:10.1016/j.jss.2020.08.060

Cited by 1 publication

(2 citation statements)

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“…The ringed graft device was the most widely used; however, its application was finally challenged. Another review study [15] showed that although the device was designed to form automated ringed anastomosis on each side of the graft, a successful two-side ringed anastomosis was performed for only half of the patients. Several researchers have previously highlighted the difficulties during the placement of a ringed graft, such as mismatch between the ring diameter and aneurysm neck or the inability to insert the ring due to extensive calcification of the vessel, which make the device use significantly dependent on the anatomy of the patient.…”

Section: Discussionmentioning

confidence: 99%

“…Several alternative methods have been suggested incorporating the use of ringed grafts, stents, staplers, couplers, or adhesives, however, none of them have successfully replaced the hand-sewn technique in everyday clinical practice. Previous research on the efficacy of such devices in end-to-end anastomosis of the aorta has shown that, although they offer a faster anastomosis and satisfactory short-term mortality rates, they are inferior in terms of tensile strength compared with the hand-sewn technique [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Precision Medicine in Aortic Anastomosis: A Numerical and Experimental Study of a Novel Double-Sided Needle

Manolesou

Korompili

Davazoglou

et al. 2021

JPM

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Background: Hand-sewn anastomosis is a crucial part of aortic reconstruction surgery and significantly affects its outcome. The present study presents a novel, bidirectional surgical needle aimed to improve aortic anastomosis in terms of speed and ease of use. Our objective was to assess the efficacy of the new design in comparison with the conventional needle. Methods: A series of simulations were conducted with COMSOL software in order to perform a fatigue comparative analysis between the new and the conventional needle design. Ease of penetration into a piece of polydimethylsiloxane was evaluated. Lastly, the prototype was tested under in-vitro conditions in comparison with the conventional needle. Results: Based on fatigue analysis, the new needle design improves durability, provided the two tips are equally used. The polytetrafluoroethylene coating improves penetration into the tissue by 7% to 17%, while electropolishing improves penetration up to 19%. When using the novel needle design, the average anastomotic task completion time was significantly reduced by 22% and the overall distance of hand movements was significantly reduced by 20%. Conclusions: The proposed design exhibited a shorter anastomotic time and seems promising in relation to ease of use and simplicity of the anastomotic technique it introduces.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%