Sutureless Microvascular Anastomosis: Literature Review

Abstract

This study followed the methods used in Preferred Reporting Items for Systematic Reviews and Meta-Analyses [4]. Eligibility criteria were specified unambiguously to ensure that studies were selected in a systematic and unbiased manner. Via PubMed, a Medline literature search was performed. Keywords used were sutureless microvascular anastomosis, vascular closure staples, laser, tissue adhesives, and Unilink. This was combined with cross-referencing from the reference lists of all recovered and relevant publications on this subject. In total, 650 publications were discovered, of which, 180 were relevant. The inclusion criteria were sutureless devices or sutureless procedures for microvascular anastomosis, English language, clinical studies, and animal research on technologies already used in clinical practice or on refinements of existing techniques. Out of the 470 articles excluded, 120 were non-animal studies or animal experimental studies with low numbers, and 350 articles were not relevant to our topic (Figure 1).

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“…The goal is to achieve optimal blood flow through the connection and reduce the risk of thrombosis. In addition, sutureless methods like adhesives, laser welding or stents may also be considered depending on the surgeon’s experience [ 135 , 138 , 139 ]. Unfortunately, there is no consensus to date on the ideal technique to resolve the problem of vessel size mismatch [ 43 , 135 , 137 ].…”

Sutureless vascular anastomotic approaches and their potential impacts

“…However, microvascular anastomosis requires high skill level, resources, and cost, reducing its access substantially. Thus, a sutureless microvascular anastomosis alternative has potential to expand access of reconstructive surgery worldwide [ [1] , [2] , [3] ].…”