Microsurgical Training in the Rat for the Arteriovenous Fistula of the Chronic Renal Failure Patients

Yoo, Chang Hyun; Kim, Jeong Hun

Abstract

For the chronic renal failure(CRF) patients arteriovenous fistula(AVF) is performed on the upper extremity. The primary site is usually the wrist including snuffbox where diameter of the vessels is small, usually one to three millimeters. The trainee of general surgery has been lack of experience of small vessel surgery. Here on the basis of experimental microsurgery, novel animal practice model of AVF was developed for the clinical application. Among several types of vascular anastomosis of AVF, side-to-side anastomosis with distal vein ligation were favored in this study. In brief, rats were anesthetized with intraperitoneal urethane injection and midline abdominal incision was made. Aorta and IVC below the left renal vein was exposed and seperated and mobilized carefully. Side-to-side and end-to-end anastomosis can be performed microsurgically. Loupe(x3.5-5) and experimental microscope may help to carry out vascular anastomosis confidently. The key-point of the procedure is that both corners of stomas were sutured for staying and from the one-end continuous sutures were done with total open-loop method.