The Usefulness of a Versatile Retractor System in Venous Anastomoses with Microvascular Anastomotic Coupler

摘要

Breast reconstruction with microvascular anastomosis has become an increasingly standard procedure. Arterial anastomoses are generally still hand-sewn, but venous anastomoses are frequently completed with a coupler device. The device overcomes the vessel limitations and also increases operative efficiency. The most widely used device is still the Synovis microvascular anastomotic device (GEM Coupler; Synovis Micro Companies Alliance, Birmingham, Ala.). Many reconstructive surgeons take the use of this device for granted, and our facility is no exception for most venous anastomoses. In its usage, the donor vein, followed by the recipient vein, is attached to the individual coupling components, and the ends of the vessels to be anastomosed are pulled through opposing rings and everted onto device pins. Irrigation of the vessels with heparinized saline is sometimes required. One significant drawback of this anastomotic device is that the surgeon has to hold the handle of the device, engaging his one hand constantly. Therefore, if there is no assistant, the surgeon has to complete the above procedures using only one hand because the other hand is constantly engaged in holding the device.