The Sutureless Microanastomosis

Gestring, G. F.; Lerner, Robert G.; Requena, Ramiro

doi:10.1177/153857448301700607

Cited by 12 publications

(10 citation statements)

References 2 publications

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“…Inlay shows detail of the GraftConnector  stent sutures remained permanently. Gestring et al 64,65 were the first to use fibrin glue for end-to-side vascular anastomoses in dogs and rabbits. They used a sutureless technique in which the angled end of the femoral artery was pulled into the femoral vein.…”

Section: Adhesivesmentioning

confidence: 99%

Non-suture methods of vascular anastomosis

Zeebregts¹,

Dungen³

et al. 2003

British Journal of Surgery

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The non-suture techniques can be categorized into five groups based on the materials used: rings, clips, adhesives, stents and laser welding. With all these techniques a faster and less traumatic anastomosis can be made compared with sutures. However, each device is associated with technique-related complications. As a consequence, suturing continues to be the standard approach. The disadvantages of the non-suture techniques include: rigidity and a non-compliant anastomosis with rings; toxicity, leakage and aneurysm formation with adhesives; early occlusion with stents; cost, reduced strength in larger-sized vessels and demand for surgical skills with laser welding. Further refinement is needed before widespread adoption of these techniques can occur. Clips, however, may be particularly promising but long-term evaluation is required.

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Section: Adhesivesmentioning

confidence: 99%

Non-suture methods of vascular anastomosis

Zeebregts¹,

Dungen³

et al. 2003

British Journal of Surgery

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“…Encouraging but limited results with FG for reduced suture and true sutureless anastomosis of hollow vessels have been reported, mainly in animal models, for arteries, veins, lymphatic vessels, esophagus, trachea, gastrointestinal tract, common bile duct, ureter, vas deferens, and uterine horn/Fallopian tubes [23][24][25][26][27][28][29][30][31][32].…”

Section: Invited Reviewmentioning

confidence: 99%

“…Many methods of autologous brinogen have been described with varied bonding strengths [21,59,74,75,78,84]. Although AFG adhesive strengths are generally inferior to those of commercial products, they are suf cent for many of the attempted surgerical procedures [21,24,59,[83][84][85][86]. Most hematology laboratories can prepare AFG quickly and economically on the same day of surgery and even intraoperatively [79,84].…”

Section: Fibrinogen Precipitation/ Autologous Fibrin Gluementioning

confidence: 99%

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Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Detweiler

Fenton

1999

Journal of Investigative Surgery

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Research in reduced suture fibrin glue (FG) and sutureless FG anastomosis has been lagging behind FG utilization in other surgical fields. A review of the literature for vascular, esophageal, tracheal, gastrointestinal, common bile duct, ureteral, vas deferens, and Fallopian tube FG anastomosis indicates that reduced suture FG and sutureless FG procedures may be performed with less training, reduced operating time, leakage, ischemia, inflammation, and necrosis compared to sutured techniques. Reduced suture FG vascular anastomosis augments early anastomotic strength. Suture number for esophageal, tracheal, and tracheobronchial anastomoses can be reduced with FG. Bursting strength in pig small intestine and rat colon was lower at 4 days postoperatively, but returned to sutured strength at 7 days. Mortality was unaffected, and 18-month follow-up in sutureless FG intestinal anastomosis in pigs showed no stenosis. Preliminary ureteral studies have demonstrated successful sutureless FG and reduced suture FG laparoscopic techniques in pigs. Reduced suture FG and sutureless FG vas deferens anastomosis may reduce sperm granuloma rates, with increased patency and pregnancy rates. Patency and pregnancy rates have been similar for tubal FG, reduced suture FG, autologous fibrin glue (AFG), and sutured anastomosis. Any risk of viral transmission or immune response is eliminated by AFG. While there are few studies in many areas of FG hollow vessel anastomosis, the current literature illustrates many of the advantages of FG over other anastomotic techniques and should provide impetus for continued research in this promising field of surgery.

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“…Gestring et al 3 described their method of end-to-side microanastomosis in dogs and rabbits using fibrin glue instead of sutures. Karl et al 4 presented their technique of end-to-end anastomosis of rat femoral vessels using only fibrin glue, without any sutures.…”

mentioning

confidence: 99%

A new method of applying fibrin glue at the microvascular anastomotic site: The “paintbrush” technique

Padubidri

Browne

1996

Microsurgery

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Fibrin glue has been used by several researchers to seal microvascular anastomoses sites. Usually the glue is delivered at the site with a syringe and needle. However, this technique can result in excess deposition of glue, which can cause intravascular thrombosis and can harden the vessel wall. We describe a new technique that avoids both these problems. We designed a "paintbrush" by inserting a suture through the syringe needle and then using the suture tip as a brush to apply the fibrin glue. End-to-side anastomoses were performed between the femoral artery and femoral vein in ten rats. Only two sutures were used to perform the anastomosis, the rest of the anastomosis being completed by sealing the gaps with fibrin glue. All the anastomoses were patent after 2 weeks, and no thromboses occurred. This is a new method for applying fibrin glue that delivers an adequate amount of fibrin glue without causing thrombosis.

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The Sutureless Microanastomosis

Cited by 12 publications

References 2 publications

Non-suture methods of vascular anastomosis

Non-suture methods of vascular anastomosis

Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

A new method of applying fibrin glue at the microvascular anastomotic site: The “paintbrush” technique

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