Experimental models in microsurgery

Abstract

The development of experimental microsurgery can be considered the natural evolution of a diffuse need to increase precision in many fields of surgery. Microsurgery accelerated the possibility of deepening many unclear aspects of pathophysiology, using miniaturized and reproducible experimental models. We report briefly on the fundamental principles of microsurgery and the most frequently performed and useful models of experimental microsurgery, especially to employ as training models for surgeons, but also as bases for developing new and always-welcome models.

Improvement of Microsurgical Techniques in Orthotopic Rat Liver Transplantation

“…The general principles of microvascular anastomoses comprise the following: a precise clear-cutting of the vessel; an avoidance of the adventitia falling into the lumen of the vessel; an assurance that the operative field remains moist to protect the vessels' elastic features; an avoidance of excessive pull of the vessel stump to avoid intimal retraction or tears; tension-free vessel stumps without kinking; rinsing of the inside of the vessels with heparinized saline solution; an introduction of the needle with clear-cut gestures perpendicular to the vessel wall; and an avoidance of piercing both edges of the vessel with 1 stitch [12][13][14][15]. Over the past 30 years, many modifications have been accomplished to facilitate the original technique of rat orthotopic liver transplantation described by Lee et al [1].…”

Arterialization of the portal stump by right renal artery after portocaval shunt in the rat

“…7 The use of arterial vessels with small caliber (right gastric artery or right renal artery) would have the advantage of avoiding hyperarterialization of the portal system, which could determine further alterations of liver structure. 5,9 Portocaval anastomosis is one of the most widely performed experimental models, and it plays a fundamental role in microsurgical training; 13,14 even though it has not been completely set up, arterialization of the portal stump represents a further evolution of this technique, and is an essential step in performing pathophysiological studies on the arterial revascularization of the liver.…”

The value of microsurgery in liver research

“…Alternatively, livers can be satisfactorily allografted in rats using the rapid cuff‐ligature technique for anastomosis (68, 69). In the simplified technique, the donor hepatic artery can be ligated because it will not be anastomosed (4). It is also possible to combine suture (suprahepatic vena cava and aortic segment anastomosis), cuff (portal vein and infrahepatic vena cava anastomosis) and stent (choledocho‐choledochostomy) anastomoses (67–69, 73, 75) (Fig.…”

“…Although some of the surgical microtechniques described here can be performed by researchers without prior surgical training, most require training in microsurgery. For surgeons interested in hepatic research, this microsurgical training is fundamental because not only does it allow them to use very productive experimental models but also it would benefit their clinical activity, both technically – their precision and skill would improve – and scientifically – they would deepen the understanding of pathophysiology and invent new ideas that could be important for the advancement of medicine (4, 79).…”