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A Practical Guide to Train the Side-to-side Anastomosis: Tips, Tricks and Technical Nuances
Juan Carlos Gomez-Vega1, Nakao Ota1, Muhammad Kusdiansah2
1Department of Neurosurgery, Far East Neurosurgical Institute, Sapporo Teishinkai Hospital, Stroke Center, Sapporo, Japan.
World Neurosurgery
|May 16, 2024
Summary
This study details a side-to-side anastomosis technique for neurosurgery, proving safe and effective for intracranial aneurysms. The described method enhances flow and reduces thrombus risk, crucial for successful microvascular procedures.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Microsurgery
Background:
- Microanastomosis is a challenging neurosurgical skill requiring specialized training.
- Consistent practice outside the operating room is vital for proficiency.
- This study focuses on the side-to-side anastomosis technique for complex aneurysms.
Purpose of the Study:
- To provide a comprehensive description of the side-to-side anastomosis technique.
- To analyze its advantages in preventing procedural failures.
- To compare this technique with other variations in the literature.
Main Methods:
- Examined the technique, characteristics, and outcomes of side-to-side bypass for anterior cerebral artery aneurysms.
- Reviewed 15 patients undergoing 17 side-to-side anastomoses at the Far East Neurosurgical Institute (FENI).
- Compared the FENI technique with published methods.
Main Results:
- The FENI side-to-side anastomosis technique demonstrated 100% patency in follow-up.
- Average anastomosis time was 27.5 minutes.
- The technique proved safe and effective for intracranial aneurysms, with satisfactory functional outcomes.
Conclusions:
- This paper offers the first detailed description of the side-to-side anastomosis technique with training resources.
- The technique improves flow dynamics and minimizes acute thrombus formation.
- Simulator and microsurgery center training are essential for skill acquisition.
