Arteriotomy scissors.
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Anastomosis, Surgical↗
Biomedical subjects
K E Korber
Publications and source records attributed to K E Korber.
A basic microsurgical skills curriculum for the plastic surgeon.
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Animals↗
Angled side wall microarteriotomy scissors: a new end-to-side microvascular anastomosis instrument.
Creation of a smooth side wall arteriotomy for an end-to-side microsurgical anastomosis can at times be difficult and time consuming. To facilitate this maneuver, a new end-to-side microarteriotomy scissor was designed for creation of recipient vessel openings from 0.5-2 mm in size. These new scissors and their recommended use are described.
Anastomosis, Surgical↗
Use of small-caliber polytetrafluoroethylene (Gore-Tex) grafts in microsurgical training.
We present the use of polytetrafluoroethylene (PTFE) graft material as a microsurgical training model that better simulates live vessel repairs. PTFE grafts have mechanical advantages over polyethylene or silicone tubing in that they better mimic the "feel" of an arterial vessel wall, thus allowing the student to perfect counterpressor maneuvers before attempting live vessel repairs. Saving the PTFE "repairs" for later comparison and study provides the student with positive feedback that is not possible with living models. This cost-effective model has helped to shorten our directed teaching program and has reduced the use of laboratory animals.
Anastomosis, Surgical↗
Heterotopic renal transplantation in the rat: an advanced microsurgical training exercise.
Microsurgical training programs have instructed trainees from many surgical specialties with the expansion of these techniques into all areas of clinical surgery and experimental research. Most programs employ the rat femoral vessel model in microsurgical training. A more complex and less frequently used model, the rat renal transplantation procedure, can be used for advanced training in microsurgical and microurological techniques and offers several advantages over other microsurgical models. In the heterotopic renal transplant model, the left kidney from a donor rat is transferred to the inguinofemoral region of a syngeneic recipient. The method of revascularization can be varied from end-to-end repairs of vessels of equal diameter to those of unequal diameter. In addition to the variety of possible vascular repairs, an advantage of this model over others is that the kidney graft can be harvested by a technician, thus reducing the time commitments of the trainee. This model is ideal for microsurgeons, immunologists, and urologists, since it affords the opportunity for developing technical skills while preparing an experimental model that can be used for further research. We describe the model, the operative techniques, and the variations one can employ in performing the vascular repairs.
Anastomosis, Surgical↗
Use of leeches in plastic and reconstructive surgery: a review.
Leeches possess properties that make them uniquely able to assist with venous compromised tissue. Their saliva contains an anticoagulant and a histamine-like vasodilator that promote local bleeding, a local anesthetic, and hyaluronidase that promotes the local spread of the other leech salivary secretions into the wound/bite. In addition, active pharyngeal peristalsis further promotes the egress of venous blood. Resurgence in the use of leeches has been stimulated by Upton in the United States and Mahaffey in Europe. Currently, leeches are used at many microsurgical centers to provide critical venous outflow for compromised tissue replantations and transfers that might otherwise be unsalvageable. As the use of leeches becomes more widespread, knowledge of leech biology and physiology is important. This review reports on Hirudo medicinalis, the species used most often medically in Europe and the United States.
Animals↗
Arteriovenous shunt construction for vascular access in the rat.
A method is described that allows high-frequency venous and arterial blood sampling in the laboratory rat. After distal ligation and division of the external jugular vein and carotid artery, sections of Teflon intravenous catheters are inserted and secured with circumferential ligatures. Between these Teflon segments, a vascular circuit is maintained with the interposition of silicone tubing. The silicone tube segment has been filled with heparinized saline, divided in half, and joined at its center by another segment of the catheter. This in situ arteriovenous (AV) shunt system is secured in the neck of the host animal by creating a subcutaneous tunnel and externalization of a portion of the shunt loop. The shunt facilitates repetitive blood sampling from the conscious rat. The procedure time is approximately 45 minutes, and patency can be assured over several days. Additional uses of the system include pretreatment injection protocols and postoperative drug therapy.
Animals↗
Replantation of a transmetacarpal amputation. A case report.
A case is presented of a 23-year-old male who sustained a traumatic transmetacarpal amputation of his nondominant hand. The injury consisted of complete severance of structures distal to the midpalm. Microsurgical reconstruction involved the primary repair of arteries, veins, nerves, extensor and flexor tendons, and metacarpal fractures. Skeletal reconstruction also employed a primary Swanson prosthesis for the fifth metacarpophalangeal (MP) joint. Early postoperative range-of-motion exercises were encouraged, with the achievement of a functionally capable replanted extremity. The general management of an amputation injury is also discussed, as it applies to a community hospital environment.
Adult↗