新静脈吻合器の考案
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概要
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With the progress in technique of vascular anastomosing method, the problem of organ transplantation is getting more attention from the various medical point of view. From begining of 1962, auto-tansplantation of a segment of the intestine was throughly investigated and studied and its technique has been accomplished to the level of near completion and this operation was performed on 20 clinical cases successfully. Key to the success of an organ-transplantation is on the vascular anastomosing method and the venous anastomsis is just as important as the arterial anastomosis which had so much emphasis stressed on in the past. A peculiarity and difficulty of the venous anastomosis in cases of organ transplantation, is one.must anastomose veins of an entirely different calibre. Anastomosis between the two same sized veins in those cases are quite rare. Sutural and non sutural vascular anastomosing methods that have been devised in the past are all concentrated on the problem of arterial anastomosis so that those methods are quite inadequate for our particular purpose. This theoretical basis, is the reason why this new venous anastomosing instrument was devised. This set of instrument is composed of, venous approximating clamps, staples adaptation clamp, that is to squeeze and apply that staples, apparatus to close the redundant vein, special forceps and staples. Special advantageous point of this apparatus is a devise of a small metallic bar that which has several indentations to receive staples come out from the opposite side at about 1mm from the tip and about 1mm from the line of those grooves there are two pins which are used for the eversion process. This metallic bar is placed back in a pair and by using this pins, abnormal flow of the venous blood that may be caused by anastomosing two different sized vein may be avoided. Approximately 90% patency was obtained on the basis of animal experiment, using 50 mongorian dogs. This apparatus was used for autografts of a piece of an intestinal segment for reconstruction of the esophagus and also supplemental flow of arterial and venous blood for elevated segment of the stomach in cases of radical operations for carcinoma of the esopnagus and their clinical results have been quite satisfactory. (1) Flat metallic bar was used to recive staples, so that approximation of the venous stumps became easy. (2) Anastomosis of two veins of different calibre is possible. (4) Patency rate is high. Possibility of contribution to the organ-transplantation by using this apparatus is so great that the author has made this report.
- 千葉大学の論文
- 1964-07-28
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