Intestinal transplantation in rats using the new technique of Cuff-Glue sutureless microanastomosis

Abstract

INTRODUCTION: Microsurgical difficulties hamper intestinal transplantation in the rat. Cuff anastomosis is a simple microanastomosis technique, but the tube inside anastomosis grounds foreign body reaction and thrombosis. We describe an intestinal transplantation in the rat using a new microanastomosis using adhesive called Cuff-Glue. METHOD: The graft consists of small bowel, ascending colon and a vascular pedicle containing aortomesenteric segment and portal vein. The portal margin is introduced into a cuff, everted, covering the outer wall and fixed to the base of the tube by three stitches. In the recipient, aorto-aorta hand sewn anastomosis is performed. The cuff is introduced into recipient portal vein and a ligature is performed to attach both margins to the cuff. The margin below ligature is pulled up, exposing both intimae where glue is deposited. The proximal margin is pulled down, sealing the borders by glue adhesion. Ligatures fixing the system are sectioned and the cuff is removed. After reperfusion, recipient’s correspondent intestine is removed en bloc and the graft is anastomosed in continuity with the remaining intestine by Cuff-Glue anastomosis. RESULTS: It was observed adequate graft reperfusion and anastomosis patency. CONCLUSION: The described model simplifies microanastomosis performance for intestinal transplantation in rats.