M. Rodolico

Experimental models in microsurgery

The development of experimental microsurgery can be considered the natural evolution of a diffuse need to increase precision in many fields of surgery. Microsurgery accelerated the possibility of deepening many unclear aspects of pathophysiology, using miniaturized and reproducible experimental models. We report briefly on the fundamental principles of microsurgery and the most frequently performed and useful models of experimental microsurgery, especially to employ as training models for surgeons, but also as bases for developing new and always‐welcome models.

FEASIBILITY OF A PORTO-INTRACAVAL SHUNT FOR LIVER TOTAL VASCULAR EXCLUSION IN THE RABBIT: PRELIMINARY REPORT

The animals do not tolerate prolonged caval and/or portal clamping which induces negative pathophysiological events such as release of chinines, damage of the intestinal mucosa, and bacterial translocation. In human liver surgery, these problems have been solved by bio‐pump for veno‐venous bypass. In order to find a simple method to reproduce a veno‐venous bypass, we developed the porto‐intracaval shunt and used it in six adult rabbits. The shunt tested was a self constructed 7‐french polyurethane shunt modeled as an inverted Y. The inferior vena cava vein below the diaphragm and below the liver and the portal vein were gently dissected. The two longer branches of the shunt were inserted in the cava vein, while the remaining branch of the Y shunt was inserted in the portal vein. After clamping the hepatic artery, the liver was partially resected in three animals and after 60 min the shunt was removed. The insertion of the shunt was always easy and the animals tolerated well the procedure and the anhepatic phase. Our study has been performed in order to test especially the technical feasiblity of this shunt in an effort to reduce portal and caval stasis during the anhepatic phase of the surgical procedures that require caval and portal clamping. The technical feasibility has been obtained but we believe that the materials and dimensions of the shunt have to be perfected and adapted depending on the size of the cava and portal veins.

Microsurgery and varicocele : State of the art

Many surgical procedures have been proposed in the treatment of varicocele; however, the rate of recurrence and of postoperative complications, together with important correlation of this disease with male sterility, has played an important role in determining the success of microsurgery. In the present brief review, the indications for microsurgery and microsurgical dissection and/or anastomosis are described in comparison to traditional surgery.