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Vascular techniques
- 1. Vascular Strasbourg, February 2001 • Basic principles • Transverse arteriotomy, embolectomy & closure • Longitudinal arteriotomy & patch closure • End to end anastomosis • End-side anastomosis
- 3. Basic Principles • Incision placement • Minimal incisions • Anatomical approach – preoperative assessment • Tissue handling • Careful dissection • Proximal & distal control • Anticoagulation • Precision of technique • Checking
- 4. Incisions & tissue handling Anatomy preoperative assessment
- 5. Dissection
- 6. Control
- 7. Transverse arteriotomy & embolectomy Strasbourg, February 2001
- 8. Transverse arteriotomy Hold vessel firmly
- 9. Embolectomy stay Place double ended stay in distal edge
- 10. Rule 1 Rule 2 Rule 3 Vascular suturing
- 11. Closure (safe) • Place all sutures • Interrupted double ended • Tie from corners
- 12. Closure (safe)
- 13. Closure (large vessel) Continuous suture = risk of narrowing Large vessels only
- 14. Longitudinal arteriotomy & patch Strasbourg, February 2001
- 16. Vein patch 1
- 17. Vein patch 2 Everting suture
- 18. Trim tip
- 19. Suture back from toe Alternative: suture around the toe finish on the “near side”
- 20. Alternative
- 21. End to end anastomosis Strasbourg, February 2001
- 22. End to end (Carrel)
- 23. Large vessel
- 24. Pursestring
- 25. Small vessel
- 26. Suture placement
- 27. Suture placement
- 28. Suture placement
- 29. Closure
- 30. Spatulated
- 31. Heel to toe
- 33. End to end – caution!
- 34. End to side anastomosis Strasbourg, February 2001
- 35. End to side
- 36. Spatulate vein
- 37. Heel suture
- 38. Toe suture
- 39. Alternative
- 40. Avoid narrowing artery (toe)
- 43. Port placement
- 45. Mesoappendix
- 46. Mesoappendix
- 47. EndoGIA