Cuff-glue sutureless microanastomosis

Hand suture microanastomosis is a difficult procedure. This report describes a simplified microanastomosis using cuff and glue apparatus. Model: Vena cava and intestine of rat were sectioned. The distal margin was introduced into an everted cuff covering the outer wall and fixed to the base of the tube by three stitches. The proximal segment was inserted into the cuff system and an encircling ligature was performed to attach both margins to the cuff. Proximal margin below ligature was pulled up exposing both intimae where glue was deposited. The proximal margin was pulled down, sealing the borders by glue adhesion. Ligatures fixing the system were sectioned and the cuff was removed. Anastomosis acquired a waveform shape, obtaining ideal intima-intima union and improving the healing process. After short training, this anastomosis can be performed within 10 min. This technique avoids cuff foreign body reaction, simplifies microanastomosis research, and may improve glue technology for tissue anastomosis. (C) 2007 Wiley-Liss, Inc. Microsurgery 27:271-276, 2007.