Related Experiment Video
Updated: Nov 18, 2025
Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
VITOM® 3D in Arterio-Venous Fistulas: Single Centre Preliminary Surgical Experience
Vincenzo Davide Palumbo1,2, Salvatore Fazzotta1, Giuseppe Damiano1
1Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
Background:
Arteriovenous fistula (AVF) is the vascular access of choice for hemodialysis patients. A correct microsurgical vascular anastomoses is essential to the optimal care of patients. Loupes can help surgeons perform such procedures, but often cause neck or back pain and fatigue.
Aim:
This study aimed to evaluate whether a video telescopic operating microscope (VITOM®; Karl Storz Endoscopy GmbH, Tuttlingen, Germany) could be used as a substitute for loupes to create microsurgical vascular anastomoses.
Methods:
We evaluated microsurgical anastomoses with VITOM® in 10 patients (6 male, 4 female) from January 2019 to December 2019. The created anastomoses were 7 side-to-side, 2 side-to-end and 1 end-to-end.
Results:
A valid thrill was always present on palpation. Surgical procedures had an average time of 87.6 min, ranging from 49 to 110 min. Eight patients had AVF maturation; in the remaining 2, one had a thrombosis after 25 days and one couldn't be dialyzed due to low flow in AVF.
Conclusions:
The VITOM® system makes it possible to carry out anastomosis in difficult cases. It is both safe and useful for the training of young surgeons.
