Pour Farid P, Arkudas A, Horch Raymund E
Plastisch- und Handchirurgische Klinik, Universitätsklinik Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
Oper Orthop Traumatol. 2024 Dec;36(6):320-331. doi: 10.1007/s00064-024-00868-4. Epub 2024 Nov 6.
Mechanical anastomoses of blood vessels represent a major advance in modern surgery. Highly specialized instruments ensure the precise connection of blood vessels, enabling the immediate restoration of blood flow. Ring coupler systems for venous anastomoses, in particular, have proven themselves in clinical practice due to their convenience and reliability and are now an indispensable part of surgical routines.
Precise and functionally proper anastomosis of blood vessels; shortening of the anastomosis time; minimization of perfusion disorders in the affected tissue; reduction of intraoperative and postoperative complications.
Replantation of extremities after amputations and injuries; defect reconstruction using free flaps; microsurgical vascular bypass procedures.
Severe vascular pathologies such as vascular aneurysms, arteriosclerosis or severe inflammation in the area of the anastomosis; large differences between the vessel lumina; too small or too large vessels.
Clamping of both vessel ends; selection of the appropriate ring coupler size based on the vessel diameter; mobilization of at least 1 cm at each vessel end; functional testing of the coupler device; threading the vessels, securely joining the rings and removing the holding device; removing clamps, inspection of the anastomosis.
Regular blood circulation checks; avoiding pressure on the anastomosis; adequate anticoagulation.
Precise anastomoses; reduction in operating time.
血管机械吻合术是现代外科手术的一项重大进展。高度专业化的器械确保血管的精确连接，能够立即恢复血流。特别是静脉吻合的环形吻合器系统，因其便利性和可靠性在临床实践中得到了验证，现已成为手术常规操作中不可或缺的一部分。
实现血管的精确且功能正常的吻合；缩短吻合时间；将受影响组织中的灌注紊乱降至最低；减少术中及术后并发症。
截肢和受伤后肢体再植；使用游离皮瓣进行缺损重建；显微外科血管搭桥手术。
严重的血管病变，如吻合部位存在血管动脉瘤、动脉硬化或严重炎症；血管腔之间差异过大；血管过小或过大。
夹住血管两端；根据血管直径选择合适的环形吻合器尺寸；在每个血管端至少游离1厘米；对吻合器装置进行功能测试；将血管穿入，牢固连接环并移除固定装置；移除夹子，检查吻合情况。
定期检查血液循环；避免对吻合部位施加压力；进行充分的抗凝。
精确吻合；缩短手术时间。
