[Mechanical vascular anastomoses].

Autor: Pour Farid P; Plastisch- und Handchirurgische Klinik, Universitätsklinik Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland. pantea.pourfarid@uk-erlangen.de., Arkudas A; Plastisch- und Handchirurgische Klinik, Universitätsklinik Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland., Horch RE; Plastisch- und Handchirurgische Klinik, Universitätsklinik Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
Jazyk: němčina
Zdroj: Operative Orthopadie und Traumatologie [Oper Orthop Traumatol] 2024 Dec; Vol. 36 (6), pp. 320-331. Date of Electronic Publication: 2024 Nov 06.
DOI: 10.1007/s00064-024-00868-4
Abstrakt: Background: Mechanical anastomoses of blood vessels represent a major advance in modern surgery. Highly specialized instruments ensure the precise connection of blood vessels, enabling the immediate restoration of blood flow. Ring coupler systems for venous anastomoses, in particular, have proven themselves in clinical practice due to their convenience and reliability and are now an indispensable part of surgical routines.
Objectives: Precise and functionally proper anastomosis of blood vessels; shortening of the anastomosis time; minimization of perfusion disorders in the affected tissue; reduction of intraoperative and postoperative complications.
Indications: Replantation of extremities after amputations and injuries; defect reconstruction using free flaps; microsurgical vascular bypass procedures.
Contraindications: Severe vascular pathologies such as vascular aneurysms, arteriosclerosis or severe inflammation in the area of the anastomosis; large differences between the vessel lumina; too small or too large vessels.
Surgical Technique: Clamping of both vessel ends; selection of the appropriate ring coupler size based on the vessel diameter; mobilization of at least 1 cm at each vessel end; functional testing of the coupler device; threading the vessels, securely joining the rings and removing the holding device; removing clamps, inspection of the anastomosis.
Postoperative Management: Regular blood circulation checks; avoiding pressure on the anastomosis; adequate anticoagulation.
Results: Precise anastomoses; reduction in operating time.
Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: P. Pour Farid, A. Arkudas und R.E. Horch geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
(© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
Databáze: MEDLINE