SLIP-KNOT SUSPENSION TECHNIQUE - A FAIL-SAFE MICROANASTOMOSIS FOR SMALL-CALIBER VESSELS

The most common technical error associated with microvascular anastomo tic failure is accidentally snagging the opposite wall and including i t in the stitch, thereby reducing the vessel lumen diameter or occludi ng it altogether. A simple, safe microsuturing technique is described that combines the use of the slip-knot and the suspension technique in a procedure that allows direct visual inspection of suture placement from first to last stitch. This technique is applicable to end-to-end and end-to-side microvascular anastomoses, for thick-walled ducts such as the vas deferens and the fallopian tube, and in laparoscopic sutur ing.