Comparative study between vascular clips and traditional suture closure in vascular anastomosis

One of the most challenging problems which takes a lot of research is to reduce the time of vascular clamping specially in some critical surgical situations e.g. carotid surgery. revascularization of the brain [superficial temporal- middle cerebral artery anastemosts] coronary bypass. organ transplantation. critically threatened loss organ or limb. A new type of vascular closure is clamed to solve this problem that is the use of vascular clips in vascular anastomosis. The aim of this work is to evaluate the use of this new method of vascular ariastomosis in comparison with the traditional suture method. Cephalo-radial end to side arterio-venous fistulae for hemodialysis were done by the use of two types of vascular closures, titanium clips and traditional sutures, ten patients from each group were randomly chosen. The suture line anastomosis in all the patients was 1.5 cm. Apart from the times of tissue dissection the times of vascular anastomosis were only calculated. Then we randomly chosed 10 patients from each group in whom their fistulae done 5 months later. Their fistulae were examined by duplex apparatus. We could conclude from this work that the time required for clip vascular anatomosis is considerably shorter than for anastmosis are nearly equal as regard the patency and degree of narrowing at the site of vascular anatomosis

Pneumatic lithotripsy for urinary calculi the swiss lithoclast

In the presence of extracorporeal shock wave Lithotripsy there is still the need for endouological treatment of stones in the urinary tract. The lithotriptors currently used are ultrasonic, electrohvdraulic and laser. We report our early experience with a new, simply costructed machine at a reasonable cost for endoscopic stone disintegration - the Swiss Lithoclast. Its idea is based on pneumatic shock waves induced by the centrally compressed air system of a hospital or by a compressor. We used this device to treat 27 patients with stones in the kidney and the urinary bladder. Stone fragmentation was successful in all patients indicating that this device may well represent an attractive alternative to standard endoscopic lithotriptors