Department of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez", UNAM, Mexico City, Mexico.
Department of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez", UNAM, Mexico City, Mexico.
World Neurosurg. 2024 Apr;184:213-218. doi: 10.1016/j.wneu.2024.01.147. Epub 2024 Feb 2.
Vascular neurosurgical procedures require temporary or permanent surgical clips to treat cerebral aneurysms, arteriovenous malformations, or bypass surgery. In this scenario, surgical clips should have specific characteristics such as high-quality material, proper design, closing force, and biocompatibility. Due to these characteristics, the price of these clips does not allow their availability at the experimental surgery laboratory worldwide.
We describe here the technique for manufacturing handcrafted clips of low cost, using dental stainless steel or titanium wire of 0.18 mm, 0.20 mm, or 0.22 mm in diameter. We must complete six steps to obtain the clip using our hands and small electrician needle nose pliers for wire molding.
These clips have a closing force of 30-60 gr/cm2 (depending on the wire diameter). They can be used in the experimental surgery laboratory to clip arteries or veins during vascular microsurgery procedures. Also, they can be used as temporary clips with confidence in low-flow bypass (v.gr. superficial temporal artery to middle cerebral artery or occipital artery to posterior inferior cerebellar artery anastomoses).
Making practical low-cost clips for use in laboratory procedures or during low-flow anastomosis as temporary clips is possible. The main advantages are the low cost and the worldwide availability of the basic materials. The main disadvantage is the learning curve to get the ability to master the manufacturing of these clips.
血管神经外科手术需要使用临时或永久性手术夹来治疗脑动脉瘤、动静脉畸形或旁路手术。在这种情况下，手术夹应具有高质量的材料、适当的设计、闭合力和生物相容性等特定特性。由于这些特性，这些夹子的价格不允许在全球的实验手术实验室中使用。
我们在这里描述了一种使用直径为 0.18 毫米、0.20 毫米或 0.22 毫米的牙科不锈钢或钛丝手工制作低成本夹的技术。我们必须完成六个步骤才能使用我们的手和小型电工尖嘴钳获得夹子。
这些夹子的闭合力为 30-60 克/厘米 2（取决于线材直径）。它们可用于血管显微外科手术中的实验手术实验室中夹闭动脉或静脉。此外，它们也可以作为临时夹用于低流量旁路（例如，颞浅动脉至大脑中动脉或枕动脉至小脑后下动脉吻合术），使用时具有信心。
制作实用的低成本夹子，用于实验室程序或作为临时夹用于低流量吻合是可行的。主要优点是成本低，基本材料在全球范围内都有供应。主要缺点是掌握制造这些夹子的能力需要一定的学习曲线。
