Incision anastomosis

Incision anastomosis. Long-term interventional catheters, heart or blood vessel patches and artificial vascular grafts need to anastomose well with... 

The primary problem with ureteral-intestinal strictures is due to scarring secondary to impaired blood flow to the site of the anastomosis. Endoscopic incision combined with balloon dilatation gives better results than dilatation alone. In contrast, a permanent stent is the preferred way to manage patients with metastatic cancer. It is important that the side holes of the pigtail should lie only in the renal pelvis and in the stoma collection bag as, if left in the conduit, they may become blocked by mucous. The stents should be changed every 4-6 months. 

Fig. 2. Safe creation of an arteriovenous anastomosis. A = Control of inflow and outflow using clamps, vessel loops or tourniquets B = incision of the artery and creating round ends using a punch C = instillation of heparinized saline solution to check the outflow of the vein and enlarge the vein so it can be marked D = mild outward rotation of the vein E = running suture inside artery out in parachute technique. 

The primary function of sutures is to hold a wound in a good position for the promotion of wound heaUng. Incised surgical wounds and clean, fresh incised traumatic wounds which are not associated with contamination or devitalized tissue can be closed with sutures, staples, or tissue adhesives. Careful apposition of tissues allows healing by primary intention, resulting in cosmetically and functionally acceptable scars in skin, nerve, or tendon. Sutures are also used in bowel anastomosis and vascular arterial anastomosis, which demand a leak-proof technique using a permanent suture. 

If the lungs are also retrieved, a modified heart-explantation technique is used. The left atrial incision is made in the middle, between the atrioventricular groove and the orifice of the left pulmonary veins. This incision is extended clockwise to the orifice of the right pulmonary veins in order to preserve enough left atrial tissue for the later left atrial anastomosis as well as enough tissue for the creation of atrial cuffs for the lung transplantation. In this case the pulmonary trunk is transected immediately in front of the bifurcation into the pulmonary arteries. 

Another paper [57] presents the results of an experimental study of small arterial anastomosis, combining suture with the cyanoacrylate tissue adhesive. At the distal end of the vessel, two parallel incisions were made, 180° apart... 

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