Three Types of Side-to-Side Microvascular Anastomosis Training Models Using Rat Abdominal Vessels

Abstract

Background

Side-to-side microvascular anastomosis is the most difficult type of anastomosis. The best way to master microvascular anastomosis technique is deliberate practice in the microsurgical laboratory.

Methods

Three types of side-to-side microvascular anastomosis using the rat abdominal vessels were presented. First, we present step-by-step technical details of common iliac artery (CIA)-CIA side-to-side microvascular anastomosis between 2 perfectly matched common iliac arteries via the in situ intraluminal suturing technique. Then, we present 2 arteriovenous side-to-side anastomosis training models using the same suturing technique: one with the CIA-common iliac vein (CIV) (CIA-CIV anastomosis) and the other with the abdominal aorta (AA) and inferior vena cava (IVC) (AA-IVC anastomosis). Diameters of CIA, CIV, AA, and IVC; the length of arteriotomy or venotomy; and the suturing time were recorded. The patency rates were evaluated immediately after the anastomosis was completed and 30 minutes later.

Results

In CIA-CIA side-to-side anastomosis, the bilateral CIAs were perfectly matched in terms of thickness, texture, and consistency. The vascular walls of the CIV and IVC were very thin, and they became transparent and collapsed after being cut open. A small-diameter thick-walled artery was anastomosed to a large-diameter, very thin, and fragile vein in the CIA-CIV and AA-IVC arteriovenous anastomoses. Three types of side-to-side anastomosis using the rat abdominal vessels were successfully performed; 100% patency rates were achieved immediately and 30 minutes postoperatively.

Conclusions

Three types of side-to-side microvascular anastomosis training models using abdominal vessels could be used to mimic different microvascular anastomotic situations.