Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy.
Surg Technol Int. 2021 May 20;38:23-27. doi: 10.52198/21.STI.38.SO1379.
Arteriovenous fistula (AVF) is the vascular access of choice for hemodialysis patients. A correct microsurgical vascular anastomoses is essential to the optimal care of patients. Loupes can help surgeons perform such procedures, but often cause neck or back pain and fatigue.
This study aimed to evaluate whether a video telescopic operating microscope (VITOM®; Karl Storz Endoscopy GmbH, Tuttlingen, Germany) could be used as a substitute for loupes to create microsurgical vascular anastomoses.
We evaluated microsurgical anastomoses with VITOM® in 10 patients (6 male, 4 female) from January 2019 to December 2019. The created anastomoses were 7 side-to-side, 2 side-to-end and 1 end-to-end.
A valid thrill was always present on palpation. Surgical procedures had an average time of 87.6 min, ranging from 49 to 110 min. Eight patients had AVF maturation; in the remaining 2, one had a thrombosis after 25 days and one couldn't be dialyzed due to low flow in AVF.
The VITOM® system makes it possible to carry out anastomosis in difficult cases. It is both safe and useful for the training of young surgeons.
动静脉瘘（AVF）是血液透析患者首选的血管通路。正确的显微血管吻合术对于患者的最佳治疗至关重要。放大镜可以帮助外科医生进行此类手术，但常常会导致颈部或背部疼痛和疲劳。
本研究旨在评估视频伸缩式手术显微镜（VITOM®；Karl Storz 内窥镜有限公司，德国图特林根）是否可替代放大镜进行显微血管吻合术。
我们在 2019 年 1 月至 12 月期间评估了 10 例（6 男，4 女）使用 VITOM®进行的显微吻合术。创建的吻合术为 7 例侧侧吻合，2 例侧端吻合，1 例端端吻合。
触诊时始终存在有效的震颤。手术平均时间为 87.6 分钟，范围为 49 至 110 分钟。8 例患者的动静脉瘘成熟；在其余 2 例中，1 例在 25 天后发生血栓形成，1 例由于动静脉瘘内血流量低而无法进行透析。
VITOM®系统可用于进行困难情况下的吻合术。对于年轻外科医生的培训来说，它既安全又实用。
