Easy and Fast Anastomosis using Microvascular Anastomotic Coupler System / 대한정형외과학회잡지

PURPOSE: We report the results of microvascular anastomosis using a microvascular anastomotic coupler (MAC) system. MATERIALS AND METHODS: Twenty cases (12 patients) of venous anastomoses performed using a coupler system were examined. The patients' age, gender, preoperative diagnosis, donor tissue, vessel diameters, size of coupler, time for anastomosis, patency rate immediately after surgery and the final survival rate of the transferred tissue were evaluated. RESULTS: The mean time for anastomosis using the coupler system was 3 min and 15 sec. The immediate patency rate after anastomosis was 100% without any leakage of blood or thrombus formation. At the final follow up, the transferred tissue survived in all cases. CONCLUSION: Microvascular anastomosis using a coupler system in orthopaedic reconstructive surgery can shorten the vascular anastomosis time and significantly reduce the total ischemic time of the transferred tissue. This system can be easily used after a short training period. This system minimizes the intimal damage of the vessel, easily overcomes the diameter discrepancy and provides secure fixation at the anastomosis site. This system can be a good strategy for substituting the conventional suture anastomosis.

Transnasal Edoscopic Reduction Of Medial Orbital Blowout Fracture

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.