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本文内容摘自Thieme出版的图书《Microsurgical Basics and Bypass Techniques》
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Fig. 5.1 Possible defects in performing anastomosis. (a)Loose knots (the sutures are in the lumen of the vessel). (b)Peeled off intima. (c)Vessel wall cut by the sutures and with the intima peeled off. (d)The adventitia is in the lumen of the vessel.
Fig. 5.2 End-to-end anastomosis on rat carotid arteries (Video 5.1). (a)Dissected carotid artery. Inset shows location of the approach and orientation of the operative field. (b)A latex background is placed under the artery. (c)A clip approximator is applied. (d)The vessel is cut at the middle and (e)is washed with heparinized saline. (f)The adventitia is gently removed from the ends of the joining vessels. (g)The cleaned ends are then moved closer to each other by moving one clip of the approximator. (h)The first two sutures are placed opposite to each other. (i)The clip approximator is rotated 180 degrees to show the other side of the vessels. (j)The back wall is sutured with separate sutures first. (k)The vessel lumen is checked from inside for any mistakes. (l)Sutures are placed on the front wall of anastomosis. (m)The clips are removed, and a small amount of bleeding is usually observed. (n)Bleeding from the needle puncture sites usually stops by itself with gentle pressure within a few minutes.
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