Fu-Yin Hsiao, Tien-Hsiang Wang

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Presentation transcript:

Combine semicontinuous and interrupted sutures for hepatic arterial microvascular anastomosis Fu-Yin Hsiao, Tien-Hsiang Wang Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

Disclosure This study is support by “Taipei Veterans General Hospital-National Yang-Ming University Excellent Physician Scientists Cultivation Program, No. 104-V-B-097.

Posterior Wall Vascular Anastomosis Current Methods Turn-over Time consuming Difficult in short vascular pedicle and small field One way up Technical depending Coupler Device Cost Difficult for arterial anastomsis

Material and Methods Including criteria: Patients received living donor liver transplantation in Taipei Veterans General Hospital. Surgical Technique: Combine semicontinuous and interrupted sutures were applied for hepatic arteries anastomosis Intraoperative Doppler examination to evaluate the flow of hepatic arteries.

Combine semicontinuous and interrupted sutures

Anastomosis of posterior wall with continuous sutures Anastomosis of anterior wall with interrupted sutures Intra-operative Doppler examination

Results Total 4 patients underwent combine semicontinuous and interrupted sutures. All artery anastomoses were completed successfully and the postoperative courses were smooth.

Discussion Methods of Anastomosis Advantages Disadvantages Interrupted sutures Easily adjustment of lumen size Time consuming Continuous sutures Safe time More hemostatic Possible purse string constriction of the lumen Hybrid sutures

J Reconstr Microsurg. 2006 Nov;22(8):617-23.

Semicontinuous and interrupted hybrid suture Safe Semicontinuous and interrupted hybrid suture Easy Fast