• Title/Summary/Keyword: anastomosis

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

  • Kim, Dong-Joo;Kim, Su-Gwan;Moon, Seong-Yong;Yoon, Jung-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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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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    • v.15 no.16
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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.

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

  • 김명철;이영원;김종만;김덕환;신상태;황수현
    • Journal of Veterinary Clinics
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    • v.16 no.2
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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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Use of the EEA Stapler for the Cervical Esophagogastric or Esophagocolonic Anostomosis (자동문합기를 이용한 경부에서의 식도-위장, 식도-대장 문합술)

  • 박승준
    • Journal of Chest Surgery
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    • v.27 no.12
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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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Development of Intelligent Robot for Anastomosis of Intestine (대장 소장 원형문합수술을 위한 지능형 로봇개발)

  • Kwun Y.M.;Hong J.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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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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Treatment of Laryngotracheal Stenosis: Combined Cricoid Augmentation by Autologous Cartilage and Laryngotracheal Anastomosis (성문하 확장과 단단문합술을 동시에 이용한 기관 및 성문하 협착증 치험 2례)

  • 정동학;김병훈;조정일;김영진
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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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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    • v.48 no.3
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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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    • v.55 no.5
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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.

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

  • 이성욱;한근조;심재준;한동섭;김태형
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.8
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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.

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

  • Jung, Young-Sik;Jeong, Jae-Ho;Choi, See-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.237-241
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    • 1986
  • In clinical microsurgery, limitation of space often prohibits rotation of a double clamp in an end-to-end anastomosis, or shortage of length of the secondary vessel in an end-to-side anastomosis does not allow visualization of the back wall. In these situation, back wall repair is extremely difficult. To overcome this problem, we use continuous suture technique without rotation of double clamp for end-to-end and end-to-side anastomosis of the 40 rat femoral arteries. After continuous sutures for microarterial anastomosis, the following results were obtained: Continuous sutures are useful in anastomosis where there is unavoidable limited access to the posterior wall and for some of the larger vessels now being anastomosed in free flap and other reconstructive surgery.

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