Cefalic Perfusión Aorto Iliac “Y” Autograft Microsurgery Techniques Training in Rat

Introduction: Training in microsurgery techniques plays a principal role in surgeons learning process. Surgeons are in charge of small caliber neurovascular structures repair, which could be damaged in traumatic or degenerative process and may need suture or graft respectively.

Since 1889 Jassinowsky described in his paper the essentials tips/stitches for suture animal arteries, in 1960 in the American College of Surgeons meeting, Jacobson and Suarez described the term “microsurgery” for 1 to 2 mm diameter vascular anastomosis in experimental research articles, with posterior papers about clinic applicability in different surgery specialties.

Actually the information, materials and knowledge development leads us to a new era in microsurgery, with microneurovascular techniques for 0.3 to 0.8 mm diameter vascular anastmosis, and simple fascicular nerves, called supermicrosurgery according to Koshima in Barcelona consensus on supermicrosurgery.

We present an intermediate to advanced difficulty microsurgery training technique that needs a carefully dissection of two different surgery fields/areas, abdominal and neck respectively, for “Y” graft harvesting at aorto iliac bifurcation. The “Y” graft is then is sutured by distal carotid-iliac anastomosis and proximal aorto - carotida. The proximal stump is ligated.

Methodology and Material: Is an experimental article about microsurgery training with a estándar protocol, Ten Wistar rats were operated at CIREXP centro de cirugía experimental de Fundacio Parc Taulí, under anesthesia an anterior abdominal approach and dissection was performed for graft harvesting after eferents arteries were ligated. An anterior cervical approach was performed for carotid exposure and graft suture. Distal and proximal anastomosis perfusión and surgery time were checked, a basic microsurgery set, a binocular microscope were used. 9.0 and 10.0 sutures were used for ligatures and anastomosis.

Results: The study is currently in development since the models are performed by the same surgeon in the annual advanced course in micro surgery as thesis.

Conclusions: We consider the new experimental model as a viable option that can be done in different courses of advanced surgical training integrating micro surgical dissection techniques, and microvascular suturing