Abstract
OBJECTIVE: The aim of this paper is to describe a simple and effective method for evaluating the quality of microvascular anastomoses performed in vitro.
METHODS: After the microvascular anastomosis has been performed in vitro, the vessel is cannulated at a distance of several millimeters from the anastomosis site with a catheter that is connected to a syringe filled with commercially available silicone glue. The silicone glue is slowly injected into the artery until the whole specimen is filled. Small leaks at the anastomosis site can be seen directly as the silicone glue will slowly extrude at the point of a leak. Then, the catheter is withdrawn and the specimen, filled with silicone, is left for several hours to solidify. Subsequently, the specimen is immersed in H2O2 for several hours in order to dissolve the tissue from the silicone cast. In this manner, the cast of the silicone represents the virtual lumen of the blood vessel and the print of the lumen surface.
RESULTS: Using this method, several important technical aspect of the anastomosis can be easily evaluated, such as diameter differences of the blood vessel, stricture, narrowing, irregularities of the vessel wall, leakage through the anastomotic site, and the alignment of the vessel walls.
CONCLUSION: The silicone cast method as described in this study can be used to evaluate some technical aspect of a microvascular anastomosis performed in vitro. Moreover, it can be used to monitor the progress of the trainee and as an aid in improving and mastering vascular microsurgery.