Special Instruments and Accessoires

The Perfect Hole
A good arteriotomy is essential for an end-to-side anastomosis. The hole should be elliptical and clean-cut, with even, steeply sloping edges. The hole should not have an irregular, ragged edge as it may weaken the wall and attract thrombosis. A well-made hole allows the surgeon to see the edges clearly, place the needle accurately, and tie sutures securely. Such a hole is hard to make, as every micro-vascular surgeon knows. Scissors just won't cut it.

Why Scissors Won't Cut it
The thick wall of a big vessel is tough and slippery. It has two layers which can separate with unappreciated ease, especially in older patients. Scissors don't just cut the vessel wall - they squeeze it, shear it, push it away, then cut it. Their action is unpredictable. Sometimes it's alarming. Sometimes it's dangerous. To make an accurate cut with scissors is difficult. Worst of all, scissors can separate a vessel wall into its two layers, cutting only the outer one and squeezing the inner one, uncut, into the lumen.

Acland-Banis Arteriotomy Clamp
The Acland-Banis Arteriotomy Clamp was developed to overcome the difficulties of creating a hole in the side of a vessel, in an end-to-side anastomosis. The device enables the surgeon to make an arteriotomy with an instrument that cuts the vessel the best - a knife. The arteriotomy clamp picks up and holds the piece of the vessel wall that is to be excised. Then, with a single curving sweep of a straight blade that is held close against the clamp tip, the ellipse is excised. The result is a perfect arteriotomy, every time.

Important!
With a practiced use, the size of arteriotomy which results is highly predictable. However, we strongly recommend a brief initial practice period on animal or fresh cadaver vessels. These vessels should be stretched out to their natural length and tension to simulate real conditions. Remember that the arteritomy will be twice as long and just as wide as the piece which is picked up and excised.


Hand Surgery
Tupper's Universal Hand Holder and Retractor Set enables the surgeon to fixate the hand in any position needed. Ball chains of varying lengths, with skin or tendon hooks, fixate the hand securely in the Hand Holder. With the patient's hand held firmly, the surgeon can work unhindered beneath a microscope.

Instrument Maintenance
Useful accessoires for Instrument maintenance 

 

 

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