Modern adjuncts and technologies in microsurgery: An historical and evidence‐based review

@article{Pratt2010ModernAA,
  title={Modern adjuncts and technologies in microsurgery: An historical and evidence‐based review},
  author={George F. Pratt and Warren Matthew Rozen and Daniel P Chubb and Iain S. Whitaker and Damien G. Grinsell and Mark W. Ashton and Rafael Acosta},
  journal={Microsurgery},
  year={2010},
  volume={30}
}
While modern reconstructive surgery was revolutionized with the introduction of microsurgical techniques, microsurgery itself has seen the introduction of a range of technological aids and modern techniques aiming to improve dissection times, anastomotic times, and overall outcomes. These include improved preoperative planning, anastomotic aides, and earlier detection of complications with higher salvage rates. Despite the potential for substantial impact, many of these techniques have been… 
View on Wiley
cronfa.swan.ac.uk
17 Citations
Background Citations
2

17 Citations

Citation Type

Citation Type

Technology‐assisted and sutureless microvascular anastomoses: Evidence for current techniques
TLDR
There is a relative paucity of high‐level evidence supporting any form of assisted microvascular anastomosis, but there is level 2b evidence suggesting a positive outcome with the use of the Unilink/3M coupler and the Autosuture VCS clip applicator.
The first smartphone application for microsurgery monitoring: SilpaRamanitor.
130 Since its introduction in the late 1950s, microsurgical reconstruction using free flaps has evolved to be the method of choice for reconstruction of large or complicated soft-tissue defects, with…
Education of microsurgical technique for young surgeons by International Society for Experimental Microsurgery West Japan and future prospects
TLDR
Through ISEM West Japan's hands-on seminar, young surgeon could improve technique and motivation for the microsurgery and there was a relation between the number of participation and the score.
ESTABLECIENDO PROTOCOLO DE APOYO EN MICROCIRUGÍA
TLDR
The Plastic Surgery Team in the Chilean Airforce Hospital has become aware of the need to develop a support protocol for microsurgery, which can be used in any setting throughout the country.
Translational microsurgery. A new platform for transplantation research.
TLDR
The training protocol revealed that the relation between the score and speed was seen, while not all the surgeons with enough experience got high score, and this training led to muster clinical skills and to apply excellent experimental works.
Microsurgery and liver research: Lumbricus terrestris, a reliable animal model for training?
A three‐dimensional stereoscopic monitor system in microscopic vascular anastomosis
TLDR
A three‐dimensional (3D) monitoring system to improve the microsurgery environment was developed and two patients with head and neck cancers who underwent tumor resections were reconstructed with free flap microsurgeries.
Silicone-based simulation models for peripheral nerve microsurgery.
The Role of Intraoperative Perfusion Assessment: What Is the Current State and How Can I Use It in My Practice?
TLDR
This review summarizes the available intraoperative technologies for planning and assessment of tissue perfusion in plastic and reconstructive surgery and recommends the evidence-based use of these tools in indicated surgical cases to improve clinical outcomes.
Near infrared spectroscopy for monitoring flap viability following breast reconstruction.
TLDR
NIRS accurately identified all compromised flaps in the authors' study and there was an evidence of changes in oxygen saturation on NIRS prior to clinical observation.
...
1
2
...

References

SHOWING 1-10 OF 155 REFERENCES
Use of a novel penetrating, sutureless anastomotic device in arterial microvascular anastomoses.
TLDR
The nitinol U-clip (Medtronic, Inc., Minneapolis, MN) is a new penetrating clip applied in an interrupted fashion that eliminates knot tying and decreases operative time and holds the potential for rapid, reproducible sutureless microvascular anastomoses.
Five years' world experience with nonpenetrating clips for vascular anastomoses.
Current techniques in the post-operative monitoring of microvascular free-tissue transfers
TLDR
This review outlines the current clinical and experimental flap monitoring methods available and outlines the aims of post-operative surveillance to improve chances of flap salvage and lower morbidity and mortality rates.
Expanding use of nonpenetrating clips in various surgical specialities.
TLDR
The various indications for use of the Anastoclip Vessel Closure System are described and categorizes them by specific surgical specialties, which include neurosurgery, urology, and gynecology, as well as plastic and reconstructive, vascular, thoracic, transplantation, hepatopancreaticobiliary, and orthopedic and trauma surgery.
[Mechanical vascular clips with an automatic stapler in reconstructive microsurgery. Apropos of 16 clinical cases].
TLDR
This clinical experience confirms the advantages of this mechanical approach to microanastomotic procedures for small vessels as previously demonstrated in experimental work: a system avoiding transfixation, rapid procedure, reliability.
Early reintervention of compromised free flaps improves success rate
TLDR
The data shows that the majority of anastomotic failures occur within the first 24 h; thereafter, the frequency of failures decreases and it is found that the time between initial reconstruction and start of the salvage procedure influences the outcome of the revision negatively.
Clinical Experience with the 3M Microvascular Coupling Anastomotic Device in 100 Free‐Tissue Transfers
TLDR
The 3M device is best suited for minimally discrepant, soft, pliable venous microvascular anastomoses and is unsuitable for end-to-side anastsomoses in clinical situations and can be a safe, fast, and reliable adjunct for free-tissue transfers.
Varioscope M5: a new type of magnification system in anterolateral thigh perforator free-flap surgery.
TLDR
The Varioscope M5 is considered an alternative option for surgical magnification in most free tissue transfers, especially when an operating microscope is not supplied.
Planning and optimising DIEP flaps with virtual surgery: the Navarra experience.
Clinical experience with non-penetrating vascular clips in free-flap reconstructions.
TLDR
Both the VCS clip-applier system and the Unilink system are easy to handle and allow fast microvascular anastomoses without intraluminal penetration and the patency rate of clipped vessels is at least as good as the patencies rates of vessels anastOMosed using sutures or rings.
...
1
2
3
4
5
...