A new technique of microvascular suturing: the chopstick rest technique

With the conventional techniques of tying knots during microvascular anastomosis or neural suturing, time may be lost due to various reasons. The loose end of the suture often falls down into the operative field and gets stuck to the surrounding tissues. In the process of retrieving the suture, the surrounding tissues can be picked up together with the suture. When the posterior wall technique [Br J Plast Surg 34 (1981) 47, Plast Reconstr Surg 69 (1982) 139, Microsurgery 8 (1987) 22, J Reconstr Microsurg 15 (1999) 321] is used, the loose end of the suture may be stuck to the backside of the vessel and may be hard to grab. In order to avoid those problems, a new way of tying a microsuture was developed. By avoiding contact of the loose end of the suture to the surrounding tissue at any point during tying, the microvascular anastomosis can be performed quicker and more efficiently.