[Intraluminal absorbable device to assist in vascular microanastomosis. Experimental study on 20 rat aortas]. / Dispositif résorbable endoluminal d'aide à la micro-anastomose vasculaire. Etude expérimentale sur vingt aortes de rats.

The subject of this experimental study is a cylindrical device, with a gauge adjusted to the vessel lumen, which disintegrates in a few minutes. The goal of this device is to increase the reliability of vascular microanastomosis. This study was designed to assess the efficacy and drawbacks of the device. The device is a cylindrical sugar stick, 5 mm long and with a gauge of 1 mm. Ten Wistar rats underwent a standard end-to-end aortic anastomosis with interrupted sutures and ten underwent the same anastomosis with the device placed in the lumen of the proximal and distal vessel. The same surgeon performed all anastomoses. Clamp application time was recorded and anastomotic patency was tested in each case; the vessels were also examined histologically. The clamp application time was significantly lower (p < 0.01), and the patency rate significantly higher (p < 0.01) in the group in which the device was used. There was no histologic sign of intima injury in either group. This very simple device facilitates microanastomosis. It reduces the ischemia time and increases the reliability of the anastomosis, avoiding transfixing sutures. These results suggest that clinical trials are warranted.

[Indications and results of breast implant replacement with implants pre-filled with silicone gel]. / Indications et résultats de l'opération déprothèse-prothèse avec implants préremplis de gel de silicone.

Based on a series of 74 patients, the authors report their experience of reoperation on unsatisfactory breast implants by the implant replacement technique using silicone prefilled implants. In 92 (57.8%) of the 160 cases, the implant was modified because of a peri-implant capsule, with a satisfactory aesthetic result after only a single operation. However, this leaves the problem of repeated surgical operations, especially in the context of Baker stage IV capsules, which are only partially improved after two to three surgical operations. A particular surgical revision technique is required in the cases, while the role of in situ cortivazol is under investigation. This series comprises two patients with auto-immune disease and dysimmune profiles, not exarcerbate by secondary surgery. Analysis of this series clearly argues in favour of reoperation for unsatisfactory breasts implants. Squeezing manoeuvres appear to be dangerous and useless. Textured implants filled with very cohesive silicone gel should be maintened in view of the absence of any reported serious complications.