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At least 127 records · Page 7Linked to original sources

PubMed2003

An automatic sutureless coronary anastomotic device: initial results of an animal study.

BACKGROUND: The efficacy and long-term patency of a new distal anastomotic device (DAD) for the creation of rapid, sutureless end-to-side venous or arterial coronary artery bypass graft anastomoses were tested in a sheep model. METHODS: The DAD was used on the beating hearts of 34 sheep to create 20 anastomoses between saphenous veins (n = 9) or internal mammary arteries (n = 11) and various coronary arteries. Fourteen conventional hand-sutured anastomoses (7 veins; 7 internal mammary arteries) served as controls. The sheep were sacrificed 1 day, 1 week, and 1, 3, and 6 months after surgery. RESULTS: The immediate patencies of all anastomoses were proven by the rates and pattern of flow. There were no significant differences between the DAD and suture anastomosis groups in presacrifice pulsatility index and occlusion rate. The histomorphometric studies showed complete intimal bridging over the DAD with no significant differences between DAD and suture anastomoses with respect to tissue response, mural injury, inflammation, and adventitial fibrosis. CONCLUSIONS: The DAD enables the creation of rapid, efficient, and sutureless venous or arterial coronary anastomoses. The long-term results of histomorphometric studies show that the results with the DAD are comparable with those of conventional hand-sutured anastomoses.

Anastomosis, Surgical↗

PubMed2004

[Sutureless lamellar keratoplasty by microkeratome combined with fibrin tissue adhesive in rabbits].

OBJECTIVE: To evaluate the feasibility and safety of sutureless lamellar keratoplasty by microkeratome combined with fibrin tissue adhesive. METHODS: Twenty-four New Zealand white rabbits were divided into two groups, the donor grafts and recipient beds were made by the microkeratome, the grafts were glued over the stoma bed using the commercial product Tisseel in one group; and grafts without tissue adhesive were used as the control group. Corneal refractive power was measured by automated keratometer preoperatively and in 3 days, 2 weeks, 1 and 3 months postoperatively. Rejection and cornea transparency were observed. Confocal microscopy was used to observe corneal wound healing response and to measure the keratocyte and endothelium densities in vivo. Corneal wound healing was also evaluated using light and fluorescence microscopy. RESULTS: Ninety-two percent (11/12 eyes) of the glued grafts were retained in the Tisseel group, whereas all grafts were lost in the control group. All survived grafts were clear 1 month after surgery. However, in the control group, severe haze in the grafts occurred 2 weeks postoperatively. Confocal microscopy showed that there was a significant decrease of the keratocyte density surrounding the lenticule-host interface, and no changes occurred in the posterior keratocyte and endothelium. Histopathologic observations demonstrated the presence of a line of amorphous eosinophilic substance in the lenticule-host interface at 3 days after surgery, but the line disappeared after 1 month. Fluorescence microscopy showed no detectable regenerated stromal tissue. CONCLUSIONS: This initial study demonstrates sutureless optical lamellar keratoplasty performed by microkeratome combined with fibrin tissue adhesive is a simple and safe technique. Stromal wound healing response to this surgery is minimal. Fibrin tissue adhesive has no influence on the cornea optical property.

Animals↗

PubMed2002

[Application of small incision sutureless surgery in cataract].

PURPOSE: To explore the advantages of nuclear manual-chop technique in small incision cataract surgery. METHODS: By randomly sampled, post-operative visual acuity, corneal astigmatism and complications (one month of follow-up) of 120 eyes of small incision sutureless surgery associated with nuclear manual-chop were compared to that of 80 eyes of traditional ECCE with IOL implantation. RESULTS: Visual acuity of 112 eyes (93.3% ) of small incision group in one week postoperatively was increased 0.5 above compared to that of 48 eyes (60%) of ECCE group. The difference was statistically significant (chi2 = 4. 73, P < 0.05). In small incision group, the corneal astigmatism was (1.01 +/- 0.97) D (n = 95) in one week postoperatively and (0.62 +/- 0.53) D (n = 90) in one month postoperatively. A significant difference existed between the small incision group and ECCE group (t = 3.1467, P < 0.01 and t = 3. 4753, P < 0.01). As for post-operative complications, in small incision group, one post-capsule rupture was recorded. CONCLUSION: Small incision sutureless surgery with manual-chop technique is worth developing and spreading because of its advantages.

Adolescent↗

PubMed1990

A new technique for sutureless intestinal anastomosis. A prospective, randomized, clinical trial.

A polyglycolic acid device has been designed for the performance of sutureless colonic anastomoses. The use of this biofragmentable anastomosis ring (BAR) was compared with conventional techniques in a prospective, randomized study of 59 patients (x age, 49 years) undergoing ileocolostomy (n = 23) or colocolostomy (n = 36). The anastomotic technique was determined at surgery by randomization (BAR, 27 patients; suture, 16 patients; staple, 16 patients). Performance of an anastomosis with the BAR required an average of 22 minutes, a stapled anastomosis required 33 minutes, and the suture technique required 37 minutes. Learning curve error contributed to the six intraoperative complications that occurred with performance of the anastomosis (BAR, three; end-to-end anastomosis [EEA] instrument, three). The two postoperative deaths were unrelated to the anastomosis. Length of hospitalization in uncomplicated patients was the same among the three groups. The 17 patients with prolonged hospitalization had complications unrelated to anastomotic technique. All patients were followed for a minimum of 6 weeks; no additional complications were identified. We concluded that 1) the BAR is a rapid, safe method for performance of sutureless anastomoses; 2) perioperative mortality and morbidity rates of the BAR are comparable to conventional techniques of suture and staple; and 3) long-term follow-up of BAR patients is warranted to determine the incidence of complications, such as structure and/or stenosis.

Anastomosis, Surgical↗

PubMed1990

Aortic replacement with composite grafts created with a sutureless intraluminal ringed prosthesis.

From 1980 to 1988, 30 patients from a total population of 123 recipients of sutureless grafts (24%) have required aortic reconstruction with a composite ringed graft. Replacement of the ascending aorta was required in 12 patients, of the aortic arch in six patients, of the descending aorta in two patients, of the thoracoabdominal aorta in two patients, and of the abdominal aorta in eight patients. Eight patients (27%) needed an emergency operation at the time of admission. No patients had permanent neurologic or renal deficits. There was no evidence of pseudoaneurysm formation, graft erosion, graft migration, or aortic bleeding in the postoperative period. Two operative deaths (7%) occurred, both in patients undergoing arch reconstruction. Composite grafts can be created that vary in length and shape, incorporate different graft materials, and accommodate the aorta and its branches. The ability to modify the sutureless prosthesis to suit the disease encountered at operation allows the quickest repair with the least chance of anastomotic complication.

Adult↗

PubMed1989

[Sutureless compression anastomosis of the distal colon and rectum. An expanded report of experiences with a total of 140 patients].

Based on animal experiments with a sutureless anastomosis, the sutureless compression anastomotic technique (AKA) was introduced to colorectal surgery. The procedure was applied to 140 patients following resections of the distal colon and rectum. The outcome was controlled prospectively. Anastomosis fistulae occurred in 8 out of 140 patients (5.7%). Excluding the 16 patients with a primary protective colostomy the leakage rate was 6.4%. Out of 67 patients with an anastomosis height of 10 cm or less, 6 developed fistulae (8.9%). Excluding the 11 patients with primary colostomy the leakage rate was 10.7%. 3 patients showed clinically inapparent fistulae in the routinely performed gastrografin enema. The clinical application of the compression-anastomotic technique revealed no disadvantage. The technique seems to have advantages due to more areactive anastomosis healing.

Anastomosis, Surgical↗

PubMed1981

Histoacryl in sutureless uretero-ureteral anastomosis: an experimental study.

Uretero-ureteral anastomosis can be compromised by tissue reaction to the suture material, extravasation of urine, and periureteral inflammatory reaction at the anastomotic site, resulting in structures. A sutureless, urine-tight anastomosis, therefore, would be the ideal solution, n-butyl 2-cyanoacrylate was used in the sutureless uretero-ureteral anastomosis in 10 dogs and resulted in a good anastomosis with no untoward reactions.

Animals↗

PubMed1994

Surgical treatment of acute type A aortic dissection with an intraluminal sutureless graft.

The surgical treatment of acute type A aortic dissection remains a great challenge to all cardiac surgeons. From January 1991 to June 1993, 21 consecutive patients (13 men and eight women, aged 34 to 74 years) underwent emergency operations to repair acute type A aortic dissection, with the aid of hypothermic circulatory arrest. The intima tear was located in the ascending aorta in 13 patients, in the aortic arch in five patients, and in the descending aorta in three patients. The dissected ascending aorta was replaced with sutureless, intraluminal vascular grafts in all 21 patients. The intima tears in the aortic arch of five patients were primarily repaired. Modified Cabrol's shunts were created in seven patients for hemostasis, and Dacron grafts were used to wrap the ascending aorta in 18 patients. Retrograde cerebral perfusion during circulatory arrest was performed on 15 patients. The circulatory arrest time was 37 +/- 10 minutes (mean +/- SD). All patients survived the operation and regained consciousness in the early postoperative period without neurologic deficit. Post-treatment follow-ups (mean, 18.2 months) were completed in all patients except one, who died 12 months after the operation as a result of a traffic accident. All of the surviving patients are doing well without any further aortic operations. Our experience suggests that surgical repair of the acute type A aortic dissection can be a simple and safe procedure if sutureless intraluminal grafts are used and hypothermic circulatory arrest and retrograde cerebral perfusion are utilized.

Acute Disease↗

PubMed1994

Thoracic aortic aneurysmectomy with a sutureless intraluminal ringed graft.

Forty-two patients underwent replacement of the thoracic aorta with a sutureless intraluminal graft. Early and long-term results were evaluated. The operative mortality rate was 7.1%. There were two postoperative complications related to a ringed graft. One complication, the formation of a pseudoaneurysm, was caused by insufficient fixation of the graft; the other, a cerebral infarction, was related to the location of the proximal anastomosis with respect to the origin of the left subclavian artery. The 3- and 5-year actuarial survival rates were 86 and 69.5%, respectively. These were similar to survival rates of age-matched controls in the general Japanese population. Replacement of the thoracic aorta using a sutureless intraluminal graft can be performed with acceptable operative mortality, with good long-term results.

Adult↗

PubMed1993

[The AKA-2 sutureless compression anastomosis of the colon and rectum].

According to own experimental studies with anastomoses without any foreign material and based on the first clinical experience with the sutureless compression anastomoses (AKA-2) in colorectal surgery on 140 patients, this anastomotic technique was applied on further 147 patients following resections of the distal colon and rectum. Excluding the 24 patients with primary protective colostomy the leakage rate was 4.0% and out of the 45 patients with an anastomosis of 10 cm or less 2 patients developed fistulae (4.4%). 3 patients showed clinically inapparent fistulae by the routinely performed gastrographin enema. On endoscopy between 2nd and 3rd postoperative week no epithelial defects were found. Due to the biological advantages regarding morphological and functional criterias and a possible oncological advantage the sutureless compression anastomoses (AKA-2) can be recommended.

Anastomosis, Surgical↗

PubMed1995

[Sutureless incision for intraocular lens implantation].

The technique of incisional construction, the degree of automatic closure and the results of postoperative induced corneal astigmatism were reported in a series of 50 eyes with 5.5 mm sutureless incision for 6.0 mm PMMA intraocular lens (IOL) implantation. The patients ages ranged from 8 to 72 years. In this study, I-stage implantation was performed on 13 eyes and II-stage implantation, on 37 eyes. In this group, 19 aphakic eyes had had the histories of penetrating injuries and 1 to 3 times of operations. 15 aphakic eyes had had histories of senile cataract extractions, 14 eyes were congenital cataracts and another 2 eyes were other kinds. The surgical maneuvers included an external scleral frown incision 5 mm in chord length, a scleral-tunnel dissection and a corneal internal valve incision into the corneal limbus for 1 mm and keeping horizontally 6.0 mm in width. All the implantations were smooth, incisions closed watertightly without leakage or shallow anterior chamber. The means value of induced corneal astigmatism was -0.16(0.71)D with a range of +1.00 to -1.50 D. The complications were less than that of sutured operations. The results suggest that sutureless incision be safe, reliable, self-closed tightly, less induced astigmatism and could be a better kind of incision for standard IOL implantation.

Adolescent↗

PubMed1996

Subacute left ventricular free wall rupture complicating acute myocardial infarction. Successful surgical repair with a sutureless technique.

The high mortality index related to surgical therapy with direct suture of rupture of left ventricular free wall following acute myocardial infarction, suggested we analyze and use alternative techniques. So we applied sutureless technique described by Padro to two patients. We used a Teflon patch fixed to the ventricular wall with a biocompatible synthetic glue, an ethyl-2-cyanoacrylate monomer, without any direct suturing of the infarcted myocardium. The two patients survived the operation and were discharged from the hospital 12 and 14 days after surgery. The sutureless technique allows, in our opinion, a more confident and safe aggressive attitude to subacute left ventricular free wall rupture.

Adhesives↗

PubMed1997

Sutureless technique: second version.

Mesh repairs have revolutionized hernia surgery. When used to patch or plug a musculoaponeurotic abdominal wall defect, the results have been much better than traditional pure tissue repairs. The difference is simple: patch and plug techniques avoid tension on tissues. The improved sutureless repair not only avoids tissue tension, it obviates the need to suture the mesh. Fixation is achieved by intra-abdominal pressure, the same force that caused the hernia. Thorough dissection of the inguinal canal and the indirect sac is essential to avoid early failure. Whereas various repairs can be used with excellent results, there is no substitute for a complete dissection of the peritoneal sac well into the iliac fossa. The improved sutureless repair offers 2 advantages over the original version: (a) type III hernias can now be repaired without opening the canal's posterior wall, and (b) the incidence of clinically evident seroma has been reduced by 90%. Most primary and recurrent groin hernias can be repaired under local or regional anesthesia on an outpatient basis. Immediate ambulation and prompt recovery accompany this technique. Most patients resume full activity and employment by the end of the first week. The procedure is simple to learn, easy to perform and less costly than other techniques.

Anesthesia, Conduction↗

PubMed1997

Laser soldering technique for sutureless urethral surgery.

Investigators have attempted sutureless surgery to decrease operative time, lessen the inflammatory response, maintain luminal continuity, and increase the ease of performing technically difficult surgery. Only recently has laser-tissue welding (LTW) been used for urologic reconstruction in humans. Herein, we present our technique of laser soldering with the half-watt diode laser and wavelength matched albumin-based solder. Our methodology of LTW relies on bonding between the outer surface of the wound edges and the solder. The 808-nm diode wavelength does not penetrate deep tissue, and thus relies on indocyanine green dye to localize photon absorption. Since 1994, we have performed LTW, as an adjunct to suturing (N = 25) and as a primary means of tissue closure (N = 11). Preoperative diagnoses included hypospadias, urethral stricture, urethral diverticulum, and urethral fistulae. Follow-up ranged between 3 months and 3 years to identify complications of wound healing, stricture, and fistula formation. In the 37 patients undergoing urethral surgery, no strictures or diverticula have resulted. None of the patients have had wound infections or poor wound healing. Overall, five patients have developed fistulas between 2 weeks and 6 months postoperatively. The location of the hypospadiac meatus was scrotal or penoscrotal in four of these patients. Two fistulas developed following sutureless urethroplasty (reoperative) after traumatic catheterization for urinary retention (one case for inadvertent catheter removal). In our initial experience, the overall complication rate using laser soldering was 19% compared to 24% in an historical control group. Half of the complications occurred in a reoperative situation. More recently, the overall fistula rate was 14%; however, for primary cases, the current fistula rate is only 6%. LTW is safe and easy to perform. The application of protein solders (+/-chromophores) have permitted far greater tensile strengths to be achieved than laser alone. Temperature-control and chromophore-control have permitted safety and efficacy to be achieved. Solder application site and technique are equally important in the success of the LTW process. A randomized, prospective study comparing LTW to suturing is ongoing.

Adolescent↗

PubMed1998

Astigmatic changes after sutureless small-incision cataract-surgery using a superior or temporal corneal incision.

The main purpose of this study is to compare the difference in surgically induced astigmatism and stability in sutureless small-incision cataract-surgery with a superior or a temporal approach. Using the Cravy- Jaffe- and Naeser-method for calculating surgically induced astigmatism, we evaluated astigmatic changes in eyes that underwent sutureless small-incision cataract surgery via the superior (66 eyes of 65 patients) or the temporal (39 eyes of 39 patients) approach. In the early postoperative period, our calculations showed a typical against the rule-shift in the corneal superior group, while the corneal temporal group showed a slight with-the-rule shift. The temporal approach proved to be more stable and provoked less induced astigmatism than the superior approach.

Astigmatism↗

PubMed2003

A light-activated surgical adhesive technique for sutureless ophthalmic surgery.

OBJECTIVE: To investigate a scaffold-enhanced, light-activated bioadhesive technique as a substitute for sutures in ophthalmic surgery. CLINICAL RELEVANCE: Suture use in ophthalmic surgery is technically demanding and time consuming and may be associated with serious complications such as inadvertent ocular penetration, which can result in retinal detachment and endophthalmitis. Bioadhesive surgery could eliminate many complications and limitations associated with the use of sutures. METHODS: The bioadhesive was composed of a poly(L-lactic-co-glycolic acid) (PLGA) porous scaffold doped with a protein solder mix composed of serum albumin and indocyanine green, which was activated with a diode laser. Extraocular rectus muscle-to-extraocular rectus muscle, sclera-to-sclera, and extraocular rectus muscle-to-sclera adhesions were created in freshly harvested tissue followed by tensile-strength testing of these surgical adhesions. RESULTS: Optimum tensile strength for muscle-to-muscle repair was achieved with 50% wt/vol bovine serum albumin and 0.5 mg/mL of indocyanine green saturated into a PLGA porous scaffold and activated with an 808-nm diode laser. The tensile strength was 81% of the native muscle's tensile strength (mean +/- SD, 433 +/- 70 g vs 494 +/- 73 g). Sclera-to-sclera adhesions achieved a mean +/- SD tensile strength of 295 +/- 38 g, whereas that for extraocular rectus muscle-to-sclera adhesions was 309 +/- 37 g. CONCLUSION: Sutureless surgery using this bioadhesive technique for various ophthalmic procedures appears feasible and may result in reduced surgical complications and cost.

Animals↗

PubMed1977

Blepharoptosis correction with the sutureless Fasanella-Servat operation.

The Fasanella-Servat operation for correction of blepharoptosis in cases where the function of the levator muscle is good can be performed effectively without the use of sutures, thus eliminating the possible complication of corneal abrasion in the postoperative period. The author has performed 12 sutureless operations with satisfactory correction in 11 cases.

Blepharoptosis↗

PubMed1993

Long-term results of sutureless phacoemulsification with implantation of a 7-mm polymethyl methacrylate intraocular lens.

In an attempt to minimize postoperative astigmatism while retaining the advantages of implanting intraocular lenses with large optics, sutureless phacoemulsification with implantation of a 7-mm polymethyl methacrylate intraocular lens was performed through a modified scleral tunnel in 100 consecutive patients. Visual and keratometric results, as well as complications, were recorded during a follow-up period of 12 months. Average uncorrected visual acuity improved from 20/153 before surgery to 20/66 as early as 1 week after surgery. Average best corrected visual acuity improved from 20/86 before surgery to 20/39 as early as 1 week after surgery. No significant changes in visual acuity were recorded thereafter. The absolute value of keratometric astigmatism was not increased significantly at any postoperative examination time. The induced cylinder shifted from 1.26 diopters x 74.40 degrees at 1 week to 1.22 D x 1.50 degrees at 1 month after surgery, without further relevant changes thereafter. Mean (+/- SD) endothelial cell loss was 7.2% +/- 6.1% at 1 month and 12.2% +/- 5.4% at 6 months after surgery. Corneal thickness was not increased significantly at any postoperative examination time. Implantation of intraocular lenses with large optics through a scleral tunnel allows quick visual rehabilitation as well as early stability of refraction.

Adult↗