Introducing a "no-touch" maneuver to manage challenging anastomoses in arteriovenous fistulae

Native arteriovenous fistula or interposition of a synthetic graft for vascular access is crucial for dialysis patients. Optimal surgical technique, microsurgery instrumentation and preventive hemostasis are considered beneficial for a successful surgical outcome. We describe a simple and novel maneuver using soft-feeding tubes to facilitate the manipulation of veins and perform successful anastomoses without using microsurgery instrumentation or vascular clamps during operations for vascular access.