Microanastomosis in large vessel size discrepancies: A novel training model.

Introduction: Different vessel diameters may challenge the completion of a high-quality anastomosis in microsurgery. In clinical practice, discrepancies in vessel size are commonly encountered. These variations can range from small to moderate, and microsurgeons typically employ established techniques, such as dilating the smaller vessel or creating an oblique cut in its wall, to address these differences. However, when confronted with larger size discrepancies, there is a lack of consensus on the optimal technique, leading surgeons to rely on their individual experiences. Although various anastomotic techniques have been proposed in recent decades, the absence of a standardised model for practicing large vessel size discrepancy anastomosis has limited comparative research.Our objective was to develop a new experimental model for practicing large vessel size discrepancy anastomosis using a live rat model.

Material And Methods: Thirty adults Winstar® rats were used to develop a novel training model, the aortofemoral anastomosis, which provides two arterial vessels with a large size discrepancy. Thirty aortofemoral anastomoses were performed using the tapered end-to-end technique by the same operator in an experimental surgery laboratory.

Results: The tapered end-to-end anastomosis technique achieved permeable anastomoses in all 30 models, as assessed using a patency test after 3 h of completion.

Conclusion: The tapered end-to-end anastomotic technique demonstrated satisfactory results in training and clinical practice. However, further research is needed to compare the different anastomotic techniques and determine the optimal approach for large vessel size discrepancies. The aortofemoral anastomosis model stands as a valuable tool for conducting such comparative studies, contributing to the enhancement of microsurgery.