• 제목/요약/키워드: Anastomosis

검색결과 1,015건 처리시간 0.032초

의도적 혈관 압박손상 후의 가토 대퇴동맥의 미세혈관 문합시 헤파린의 국소세척 및 전신투여 효과에 대한 실험적 연구 (EXPERIMENTAL STUDY ON THE EFFECTS OF LOCAL IRRIGATION AND SYSTEMIC HEPARIN ADMINISTRATION ON MICROVASCULAR ANASTOMOSIS OF THE RABBIT FEMORAL ARTERY WITH INTENDED CRUSH INJURY)

  • 김동주;김수관;문성용;윤정훈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권2호
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    • pp.132-140
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    • 2007
  • This study compared the histological patency rates of anastomoses of the femoral artery. Twelve rabbits weighing about 2 kg were studied. Both the right and left femoral arteries were cut. The control group had no damage to the vessel, saline irrigation, and micro-anastomosis. Experimental group I had a crush injury to the vessel, saline irrigation, and micro-anastomosis. Experimental group II had a crush injury, saline irrigation, 100 U/ml heparin irrigation, and micro-anastomosis. Experimental group III had the same treatment as experimental group II plus the systemic application of 100 U/kg heparin iv. The histological patency rates were compared. The patency rates of the control group 30 min and 3 days after the anastomosis were 100 and 83%, respectively. The respective rates for experimental groups I and II 30 min and 3 days after the anastomosis were 100% in all cases. The respective rates in experimental group III were 100 and 83%. In this study, no significant correlation was observed between the patency rate and the effects of local irrigation or the systemic application of heparin on the microvascular anastomosis of the rabbit femoral artery. However, the patency rate tended to decrease concomitantly with an increase in surgery time. Increased bleeding was observed after the systemic application of heparin. Obvious damage to the crush-injured vascular endothelium was detected on histologic examination of the micro-anastomosed area. In addition, some vessels subjected to crush injury contained thrombi attached to the vascular endothelium. No preventive effect of heparin on thrombus formation was observed.

New Technique of Intracorporeal Anastomosis and Transvaginal Specimen Extraction for Laparoscopic Sigmoid Colectomy

  • Wang, Zheng;Zhang, Xing-Mao;Zhou, Hai-Tao;Liang, Jian-Wei;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권16호
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    • pp.6733-6736
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    • 2014
  • Background: Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Recently, natural orifice specimen extraction (NOSE) and intracorporeal anastomosis have been proposed to minimize abdominal wall trauma and improve the quality of laparoscopic colon resections Objective: To evaluate the feasibility and safety of a new approach combining intracorporeal delta-shaped anastomosis and transvaginal specimen extraction for totally laparoscopic sigmoid colectomy. Materials and Methods: Mobilization of bowel and dissection of lymph nodes were performed laparoscopically. After both proximal and distal incisal edges about 10.0 cm distance from sigmoid neoplasm were transected with an Endoscopic Linear Cutter-Straight, a small incision about 1.0 cm was created on the each colon wall of the contralateral side of the mesentery. Then anvils of an Endoscopic Linear Cutter-Straight were inserted into each colon through the small incisions, and incision and anastomosis between the walls of each colon were performed with a linear stapler. A V-shaped anastomosis was made on the wall and the remnant openings was reclosed with the Endoscopic Linear Cutter-Straight. The culdotomy was enlarged with laparoscopic ultrasound dissector. Transvaginal extraction of specimens was accomplished through a wound protector. Results: Surgery was performed for 11 patients with sigmoid cancer. No intraoperative complications or conversions occurred. The mean operating time was 132 min. All the patients were treated laparoscopically without any postoperative complications. Conclusions: The procedures of intracorporeal delta-shaped anastomosis and transvaginal specimen extraction are safe and oncologically acceptable for selected colon cancer cases.

개에서 경정맥문합술의 영향에 관한 초음파 관찰 2례 (Ultrasonographic Observation on the Effects of Anastomosis of the Jugular Vein in Two Dogs)

  • 김명철;이영원;김종만;김덕환;신상태;황수현
    • 한국임상수의학회지
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    • 제16권2호
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    • pp.519-522
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    • 1999
  • This study was performed to determine the effects of anastomosis on the internal diameter and wall thickness of jugular vein. Tro shepherd dogs were used for this experiment. In dog 1, xylazine(2 mg/kg) and ketamine(5.5 mg/kg) were injected intramuscularly for induction followed by enflurane(3%) anesthesia. In dog 2, acepromazine(0.03 mg/kg) and ketamine(5 mg/kg) were injected intravenously for induction followed by enflurane(3%) anesthesia. The dogs were heparinized(1 mg/kg) for the prevention of thrombosis. After jugular vein was exposed by incision of left cervical area, two Johns Hopkins bulldog clamps were clamped. Jugular vein was cut between two clamps, and it was reanastomosed using 5-0 silk. Ultrasonography was done along the jugular vein on both sides of each dogs 21 days after anastomosis surgery. The internal diameter and circumference of the vein in the anastomosis area were markedly reduced with thickening of the vein wall, but no thrombi were observed.

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자동문합기를 이용한 경부에서의 식도-위장, 식도-대장 문합술 (Use of the EEA Stapler for the Cervical Esophagogastric or Esophagocolonic Anostomosis)

  • 박승준
    • Journal of Chest Surgery
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    • 제27권12호
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    • pp.1060-1065
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    • 1994
  • For most surgeons, stomach and colon are the first choice for reconstruction of the esophagus, as well as for bypass. When the esophagogastric or esophagocolonic anastomosis is made in the neck, cervical anastomosis site leakage is the main complication. In our most recent four patients who underwent a transhiatal & posterior mediastinal esophagogastric or esophagocolonic anastomoses following esophageal resection, we performed the cervical anastomoses with a circular EEA stapler. No leaks have developed at the anastomosis site. In these four patients the cancer was tiny and was located on the upper or middle third of the thoracic esophagus. A total esophagectomy was performed by blunt resection without thoracotomy. Surgical staplers have been used previously for esophagogastric anastomosis through a right thoracotomy with a very low rate of leakage. When the esophagogastric or esophagocolonic anastomosis is performed in the neck, the prevalence of leakage does not increase the postoperative mortality, but it can increase significantly the duration of hospitalization and morbidity. The use of the circular stapler allowed us to perform four consecutive cervical esophagogastric & esophagocolonic anastomoses without any leakage and to shorten the operating time.

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대장 소장 원형문합수술을 위한 지능형 로봇개발 (Development of Intelligent Robot for Anastomosis of Intestine)

  • 권용민;홍정화
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2005년도 추계학술대회 논문집
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    • pp.139-143
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    • 2005
  • As increasing gastrointestinal pathologies, general and thoracic surgeries using circular staplers have been dramatically increased. Because of convenience for surgical procedure, recently, various circular staplers for anastomosis have been used widely. Since the circular staplers conventional have used the displacement control method, however, the anastomosis could have various biomechanical conditions. To do that, biomechanical system of gastrointestinal soft tissue should be examined to control the anastomotic condition. In this study, a new intelligent robot used in circular anastomosis. The intelligent robot driven by a stepper motor and controlled by a digital signal processor.

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성문하 확장과 단단문합술을 동시에 이용한 기관 및 성문하 협착증 치험 2례 (Treatment of Laryngotracheal Stenosis: Combined Cricoid Augmentation by Autologous Cartilage and Laryngotracheal Anastomosis)

  • 정동학;김병훈;조정일;김영진
    • 대한기관식도과학회지
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    • 제3권1호
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    • pp.148-153
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    • 1997
  • Laryngotracheal stenosis is one of the most troublesome diseases in the Em field. Subglottic stenosis can be treated by a cricoid augmentation with rib cartilage. In case of tracheal stenosis, the treatment of choice is by tracheal end-to-end anastomosis after resection of the stenotic site. However, in case of subglottic stenosis combined with tracheal stenosis, it is hard to manage. Even though several methods(such as thyrotracheal anastomosis) have been tried, they have some limitations too much excision of normal trachea and too much pulling up of the trachea after resection of the stenotic lesion. The authors have managed two cases of laryngotracheal stenosis as an anterior and posterior subglottic augmentation with an autologous cartilage graft and laryngotracheal anastomosis. The first few weeks after the operation, we could do a decannulation successfully, but in one case the patient developed restenosis. Even though one case was unsuccessful, the authors believe that this method could be used in the treatment of laryngotracheal stenosis.

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Postoperative care after lymphaticovenous anastomosis

  • Chan, Jeffrey C.Y.;Taranto, Giuseppe Di;Elia, Rossella;Amorosi, Vittoria;Sitpahul, Ngamcherd;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • 제48권3호
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    • pp.333-335
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    • 2021
  • In this report, we discuss the postoperative protocol for patients undergoing lymphaticovenous anastomosis (LVA) in our unit. Immediately after LVA, the incision site is closed over a small Penrose drain and a simple gauze dressing is applied without compression. In the first 5 days, ambulation is allowed, but limb elevation is actively encouraged to promote lymphatic flow across the newly formed anastomosis. Prophylactic antibiotics are routinely given to prevent infection because this patient group is susceptible to infections, which could trigger thrombosis in the anastomosis.

New Atrial Anastomosis Technique for an Inadequate Left Atrial Cuff in Lung Transplantation

  • Son, JeongA;Hyun, Seungji;Haam, Seokjin;Kim, Do Hyung
    • Journal of Chest Surgery
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    • 제55권5호
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    • pp.425-427
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    • 2022
  • In lung transplantation surgery, the pulmonary veins are anastomosed by connecting each atrium of the donor and recipient. However, occasionally the recipient's left atrium is not suitable for anastomosis for various reasons. In these cases, several techniques for atrial anastomosis have been introduced, but these are somewhat complicated for an inexperienced surgeon. Here, we propose a new atrial anastomosis technique that is easier and safer than previously introduced techniques.

단순봉합모델을 이용한 문합에서 탄성경계층의 두께 변화에 따른 기계역학적 거동에 관한 연구 (The Study on the Mechanical Behavior of the Anastomosis with respect to the Thickness Variation of Elastic Foundation Using Simplified Suturing Model)

  • 이성욱;한근조;심재준;한동섭;김태형
    • 한국정밀공학회지
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    • 제21권8호
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    • pp.188-195
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    • 2004
  • In this paper we analyzed the mechanical behavior with respect to the thickness variation of elastic foundation(fatty tissue) in end-to-end anastomosis. This study considered the preliminary deformed shape induced by suturing in the anastomosis of coronary artery and PTFE with different diameters using simplified suturing model and the fatty tissue surrounding heart and coronary artery for more accurate result using finite element method. Area compliance(CA) was used to analyze the final deformed shape of the anastomotic part with respect to the thickness variation of fatty tissue under mean blood pressure, 100mmHg(13.3㎪). And Equivalent and circumferential stresses in the anastomosis were also analyzed with respect to the change of initial diameter ratio( $R_1$) and fatty tissue thickness( $T_{F}$). The results obtained were as follows : 1 When the elastic foundation, assumed to be incompressive material, surrounded the grafts in anastomosis, the compliance mismatch of artery and PTFE was reduced by 47 -72%. 2. As the initial diameter ratio( $R_1$) became larger, the higher difference of compliance was induced in spite of elastic foundation surrounding grafts. 3. The maximum nondimensional circumferential stress is twice or three times as high as the maximum nondimensional equivalent stress in the anastomotic part.t.

미세혈관 수술시 혈관개존율 향상을 위한 연구 (Continuous Sutures for Microarterial Anastomosis)

  • 정영식;정재호;최시호;설정현
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.237-241
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    • 1986
  • 본 교실에서 백서의 대퇴동맥을 이용하여 혈관감자의 회전없이 continuous suture로 미세혈관 문합을 시행해본 결과 다음과 같은 결론을 얻었다. end-to-end anastomosis시 double c1app의 회전이 어려울 정도로 작업공간이 제한된 경우나 end-to-side anastomosis시 secondary Vessel의 길이가 짧아서 후벽을 잘 볼 수 없는 경우에 continuous suture을 이용하면 Back wall을 완전히 노출시킨 상태에서 쉽게 혈관 문합을 시행할 수 있으며 문합시간도 단축시킬 수 있을 것으로 사료된다.

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