A modified technique of end-to-side microvascular anastomosis for the posterior wall.

A modified technique of interrupted suturing for the posterior wall in end-to-side microvascular anastomosis is presented. It has advantages, especially for the suturing of the pedicle vein and the internal jugular vein in head and neck reconstructions when the pedicle vessel is so short that it cannot be turned over to expose the posterior wall. The pedicle vein is located vertical to the internal jugular vein, and the first stitch begins at the left end of the vessels for a right-handed person. To facilitate the exposure of the left edge of the vessels, the donor vessel is rotated approximately 90 degrees. The advantage of our technique is clear visualization of each suture by rotating the pedicle vessel. Subsequent to the interrupted suturing of the posterior wall, the anterior wall can be sutured by conventional methods. This modified technique is useful for end-to-side microvascular anastomosis, which the microsurgeon may find useful.