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Straight needle with fingertip support technique reduces exclusion time during bypass (in vitro, in vivo animal study): a technical note

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Abstract

Background

The duration of exclusion time of recipient artery is an important factor in bypass surgery of cerebral revascularization. The longest period of exclusion is the suturing time. The fingertip support technique (first published in 2006) reduced the physiological tremor to speed up this extra-precise microsurgical procedure. The use of a straight needle proved to further decrease suturing time during the bypass procedure.

Methods

A straight micro needle was added to the fingertip support method for further reduction of exclusion time. A comparative study, measuring the duration of suturing time in vitro and in vivo for animal cases, was performed. This was a golden opportunity to examine how to simplify vascular transposition, using the fingertip support technique and straight needle.

Results

The average time of the bypass procedure by the novel considerations (fingertip support and straight needle) was significantly less than the average time by traditional microsurgical support.

Conclusion

This in vitro/in vivo animal study provides evidence of the reduction of the suturing time, and thus the exclusion time, by using the fingertip support technique with a straight needle in the bypass procedure.

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Acknowledgements

Special thanks to Professor Zoltán Nagy M.D. Ph.D.D.Sc. (Head of Laboratory of Cardiovascular Surgery of Semmelweis University Budapest, Hungary,) and to his colleague Professor Violetta Kékesi, for the possibility of performing animal operations. We thank artist Balázs Sándor Papp–Muhari for the medical illustrations.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. BAZ County Hospital, Department of Neurosurgery, 72-76 Szentpéteri kapu, 3526, Miskolc, Hungary

    András Csókay & Attila Papp

  2. St. Margit Hospital, Department of Surgery, Budapest, Hungary

    Domonkos Imreh

  3. Semmelweis University, Budapest, Hungary

    Attila Papp

  4. St. John’s Hospital, Department of Neurosurgery, Budapest, Hungary

    István Valálik

Authors
  1. András Csókay
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  2. Domonkos Imreh
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  3. Attila Papp
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  4. István Valálik
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Corresponding author

Correspondence to András Csókay.

Additional information

Comment

The device shown in this technical note looks to reduce the tremor and speed-up the suture time which thereby reduces the occlusion time. Nevertheless, the manipulation of a straight needle requires some minimal room around the suture, to avoid any damage to the tissues that surround the anastomosis field. Obviously, there are some limitations for its use in the depth of the sylvian fissure.

Pierre-Hugues Roche, Marseille, France

We certify that this manuscript is a unique submission and is not being considered for publication with any other source in any medium.

We certify that this paper was not presented at any conference, and does not have a Clinical Trial Registration Number.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Part 1. Fingertip Support Technique during right pterional approach. Part 2. The tremor by fingertip support technique above mm paper. Part 3. Suturing during end to side bypass, using traditional support with curved micro needle. Part 4. Suturing during end to side bypass, using fingertip support technique with straight needle. Part 5. Suturing during end to side bypass, using fingertip support technique with straight needle (in vivo rat implanted chicken artery anastomosed to abdominal rat artery). (WMV 25350 kb)

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Csókay, A., Imreh, D., Papp, A. et al. Straight needle with fingertip support technique reduces exclusion time during bypass (in vitro, in vivo animal study): a technical note. Acta Neurochir 154, 1851–1854 (2012). https://doi.org/10.1007/s00701-012-1468-0

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  • DOI: https://doi.org/10.1007/s00701-012-1468-0

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