Ohtsuka Toshiya, Ninomiya Mikio, Nonaka Takahiro, Maemura Taisei
Department of Cardiovascular Surgery, Tokyo Metropolitan Fuchu General Hospital, Tokyo, Japan.
Heart Surg Forum. 2004;7(6):E559-61. doi: 10.1532/HSF98.20041127.
This article describes our clinical experience with a new needle driver (Olympus, Tokyo, Japan), which we have produced to facilitate minithoracotomy or port-access coronary artery anastomosis with the running suture technique.
The needle driver is 21 cm long, weighs 38 g, and has a grip shaft 1.4 cm in diameter. The device is held like a pencil. A side lever and a revolving disk in the shaft are manipulated with the fingers; a fine needle with a 7-0/8-0 monofilament suture can be grasped/released and driven to penetrate the coronary arterial wall. This device was employed in 10 consecutive patients (8 men, 2 women, 73 +/- 7.5 years old), and off-pump bypass to the left anterior descending artery was achieved using the left internal thoracic artery or vein via a minithoracotomy (4.2 +/- 0.6 cm long).
There was no instrument-related injury during each anastomosis. The mean sewing time per anastomosis was 12 minutes (range, 8-18 minutes). Angiography confirmed the patency of the graft in all cases.
Although our experience is limited, we consider the present needle driver to be a viable device for facilitating off-pump, minientry coronary artery anastomosis with the suturing technique.
本文介绍了我们使用一种新型持针器(日本东京奥林巴斯公司生产)的临床经验,该持针器是我们为便于采用连续缝合技术进行微创开胸或端口入路冠状动脉吻合术而制作的。
该持针器长21厘米,重38克,握柄轴直径为1.4厘米。握持该装置时如同握铅笔一样。通过手指操作轴上的侧杆和旋转盘;可抓取/松开带有7-0/8-0单丝缝线的细针,并驱动其穿透冠状动脉壁。连续10例患者(8例男性,2例女性,年龄73±7.5岁)使用了该装置,通过微创开胸(长4.2±0.6厘米)经左胸廓内动脉或静脉对左前降支进行非体外循环搭桥术。
每次吻合过程中均未发生与器械相关的损伤。每次吻合的平均缝合时间为12分钟(范围8 - 18分钟)。血管造影证实所有病例中移植血管均通畅。
尽管我们的经验有限,但我们认为目前的持针器是一种可行的器械,有助于采用缝合技术进行非体外循环、小切口冠状动脉吻合术。