Wir möchten die Anästhesie-Abteilung im Kinderkrankenhaus von Michigan danken für ihren Einsatz und die Finanzierung dieses Projektes. Wir möchten die BMC-Abteilung am St. Jude Children Research Krankenhaus danken für ihre künstlerische Arbeit.

<ol><li> Ein Endotrachealtubus Größe geeignet für das Alter des Patienten für die endotracheale Intubation sollte gewählt werden. Wir benutzen die Formel: ETT size = Alter (Jahre) / 4 +4. </li><li> Wir haben uns für eine Nummer kleiner ohne Manschette Endotrachealtubus zu nasal eingefügt werden, falls die Intubation nicht, nachdem der Patient in den Ruhezustand versetzt. </li><li> Vor nasal Einführen des Rohres, messen wir die ungefähre Entfernung von der Nase auf das Niveau der Stimmbänder, die in der Regel auf der Ebene der Mitte Schildknorpel. </li><li> Nachdem der Patient narkotisiert, und nach einem fehlgeschlagenen Intubation Versuch und scheiterte Lüftung, die gut geschmierten eine Nummer kleiner Endotrachealtubus wird nasal auf ein Niveau knapp oberhalb der Stimmbänder eingefügt werden. </li><li> Man muss eine gute Abdichtung des Mundes und der Nase des Patienten zu gewährleisten. Die Anästhesie-Schaltung kann der Tubus-Anschluss angeschlossen werden und mit entsprechenden Siegel des Mundes und der Nase, der Lunge ausreichend belüftet werden. </li></ol> Nach Verschließen der Nase und den Mund, sind Lunge ausreichend belüftet als bestätigt ETCO2 Wellenform, Brust hob der Patienten und eine gute Sauerstoffsättigung auf Pulsoximeter.

<ol>
	<li>Heidegger, T., Gerig, H. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Algorithms+for+management+of+the+difficult+airway.">Algorithms for management of the difficult airway.</a> Curr Opin Anaesthesiol. 17, 483-484 (2004).</li><li>Krafft, P., Schebesta, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alternative+management+techniques+for+the+difficult+airway:+esophageal-tracheal+Combitube.">Alternative management techniques for the difficult airway: esophageal-tracheal Combitube.</a> Curr Opin Anaesthesiol. 17, 499-504 (2004).</li></ol>

Diese Technik ist vergleichbar mit einem supraglottischer, wie eine Larynxmaske 1 oder eine Combitube 2, die beide, die erfolgreich als Rettungs-Techniken in CICV Situation beschrieben, um Belüftung und Sauerstoffversorgung als nonsurgical Technik zu gewährleisten. Das ETT-Technik hat jedoch die einfache Verfügbarkeit und Bereitschaft, nicht notwendig eine besondere Ausbildung oder Ausrüstung. In Fällen von CICV, und besonders bei Neugeborenen und Kleinkindern kann Sauerstoffentsättigung sehr schnell geschehen und kann lebensbedrohlich sein. Das ETT-Technik können einige wertvolle Zeit durch die Versicherung Oxygenierung und Ventilation des Patienten zu kaufen, und kann die Sättigung eines cyanosed CICV Kind wieder auf 100% zu bringen, bevor ein anderer versuchen, intubieren bereit ist zu tun. Die Grenzen des ETT Technik könnte das Risiko von Blutungen durch nasale Einsetzen der ETT werden. Dies kann durch eine gute Schmierung der Röhre vor dem Einsetzen und die Verwendung eines Vasokonstriktor-Agent in das Nasenloch vor dem Einsetzen der Röhre gesprüht minimiert werden, wenn mal erlaubt, die getan werden. Eine sanfte Rotation des ETT beim Einführen kann auch minimieren Blutungen. Das ETT-Technik fehlt auch die Fähigkeit zum Schutz der Atemwege gegen Aspiration. Auch die größere der Patient, desto steifer der Brustwand und der immer schwieriger, die Patienten mit dieser Technik zu lüften. Allerdings ist schnell Entsättigung der Regel mit Neugeborenen und kleinen Kindern begegnet, wo diese Technik sehr gut funktioniert und kann Leben retten!

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<td>ETT size appropriate for patient's age: ETT=age/4 +4</td>
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<td>tape to protect the eyes</td>
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<td>decongestant and lubricant to use in the nostril</td>
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<td>ASA standard anesthesia monitors</td>
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<td>red rubber suction catheter</td>
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a novel rescue technique for difficult intubation and difficult ventilation

Wir beschreiben eine neue, nicht operative Technik zur Oxygenierung und Ventilation in einem Fall von schwierigen Intubation und Beatmung schwierig, die besonders gut mit schlechten Maske fit zu halten. Kann nicht intubiert, kann nicht lüften &quot;(CICV) ist eine potenziell lebensbedrohliche Situation. In diesem Video haben wir eine Simulation der Technik, die wir in einem Fall von CICV wo Oxygenierung und Ventilation durch das Einfügen eines Endotrachealtubus (ETT) gehalten wurden gegenwärtigen nasal bis auf die Ebene des Nasenrachenraumes während Dichtung im Mund und Nasenlöcher für eine erfolgreiche Überdruckbeatmung. Ein 13 Jahre alter Patient wurde in den Operationssaal zur Inzision und Drainage von einem Hals abcess und direkte laryngobronchoscopy genommen. Nach Präoxygenierung wurde Anästhesie induzierte intravenös. Maskenbeatmung wurde festgestellt, dass es äußerst schwierig, weil die Schwellung der Weichteile. Die Gesichtsmaske konnte nicht richtig fit auf dem Gesicht wegen der erheblichen Schwellungen im Gesicht sowie. Eine direkte Laryngoskopie wurde ohne Visualisierung des Kehlkopfs versucht. Sauerstoffsättigung war schwierig zu pflegen, mit Sättigungen fallen um 80%. Um mit Sauerstoff und Raum gut lüften Patienten wurde ein Endotrachealtubus dann nasal nach Nasenspray mit Abschwellen der Nasenschleimhäute und Schmiermittel eingesetzt. Das Rohr wurde sanft und blind in den Hypopharynx geschoben. Der Mund und Nase des Patienten wurden von Hand versiegelt und Überdruckbeatmung wurde mit 100% O 2 mit guter Sauerstoffsättigung möglich während dieser Zeit. Sobald der Patient war stabil und gut sediert wurde ein starres Bronchoskop durch den HNO-Arzt zeigt umfangreiche subglottischen und epiglottischen Ödeme und eine Masse ab dem Abszess, die zur Beeinträchtigung der Atemwege eingeführt. Die Atemwege wurde mit einem ETT Rohr durch den otolaryngologist.This video gesichert wird eine Simulation der Technik bei einem Patienten eine Vollnarkose für Zahnersatz zu zeigen.

Watch this Scientific Journal Video about A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation at JoVE.com

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Wir beschreiben eine Technik, um Oxygenierung und Ventilation mit Hilfe eines Endotrachealtubus nasal auf die Ebene des Nasenrachenraumes eingefügt werden, während Abdichtung der Mund und Nasenlöcher für eine erfolgreiche Überdruckbeatmung aufrecht zu erhalten.

A Novel Rettungs-Technik für die schwierige Intubation und Beatmung Schwierige

We describe a novel non surgical technique to maintain oxygenation and ventilation in a case of difficult intubation and difficult ventilation, which ...

a-novel-rescue-technique-for-difficult-intubation-difficult

Nanyang Technological University

Research

JoVE Journal

Medicine

21.4K Aufrufe.  Children’s Hospital of Michigan. Wir beschreiben eine Technik, um Oxygenierung und Ventilation mit Hilfe eines Endotrachealtubus nasal auf die Ebene des Nasenrachenraumes eingefügt werden, während Abdichtung der Mund und Nasenlöcher für eine erfolgreiche Überdruckbeatmung aufrecht zu erhalten.

Serie: A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

A Novel Capsulorhexis Technique Using Shearing Forces with Cystotome

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye.
Method:
Our technique involves creating the initial anterior capsular tear with a cystotome to raise a flap. The flap left unfolded on the lens surface. The cystotome tip is tilted horizontally and is engaged on the flap near the leading edge of the tear. The cystotome is moved in a circular fashion to direct the vector forces. The loose flap is constantly swept towards the centre so that it does not obscure the view on the tearing edge.
Results:
Our technique has the advantage of reducing corneal wound distortion and subsequent anterior chamber collapse. The capsulorhexis flap is moved away from the tear leading edge allowing better visualisation of the direction of tear. This technique offers superior control of the capsulorhexis by allowing the surgeon to change the direction of the tear to achieve the desired capsulorhexis size.
Conclusions:
The EYESI Surgical Simulator is a realistic training platform for surgeons to practice complex capsulorhexis techniques. The shearing forces technique is a suitable alternative and in some cases a far better technique in achieving the desired capsulorhexis.

This video demonstrates a novel capsulorhexis technique in modern cataract surgery. Capsulorhexis is the most difficult and important part of phacoemulsification surgery.

A Novel Capsulorhexis Technik unter Verwendung von Scherkräften mit Cystotome

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye....

Forschung

Medizin

A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome

Part 1 : Purpose: To demonstrate a capsulorhexis radial tear out rescue technique using a cystotome on a virtual reality cataract surgery simulator and in a human eye. Part 2 : Method: Steps: When a capsulorhexis begins to veer radially towards the periphery beyond the pupillary margin the following steps should be applied without delay. 2.1) Stop further capsulorhexis manoeuvre and reassess the situation. 2.2) Fill the anterior chamber with ophthalmic viscosurgical device (OVD). We recommend mounting the cystotome to a syringe containing OVD so that the anterior chamber can be reinflated rapidly. 2.3) The capsulorhexis flap is then left unfolded on the lens surface. 2.4) The cystotome tip is tilted horizontally to avoid cutting or puncturing the flap and is engaged on the flap near the leading edge of the tear but not too close to the point of tear. 2.5) Gently push or pull the leading edge of tear opposite to the direction of tear. 2.6) The leading tearing edge will start to do a 'U-Turn'. Maintain the tension on the flap until the tearing edge returns to the desired trajectory. Part 3 : Results: Using our technique, a surgeon can respond instantly to radial tear out without having to change surgical instruments. Changing surgical instruments at this critical stage runs a risk of further radial tear due to sudden shallowing of anterior chamber as a result of forward pressure from the vitreous. Our technique also has the advantage of reducing corneal wound distortion and subsequent anterior chamber collapse. Part 4 : Discussion The EYESI Surgical Simulator is a realistic training platform for surgeons to practice complex capsulorhexis tear-out techniques. Capsulorhexis is the most important and complex part of phacoemulsification and endocapsular intraocular lens implantation procedure. A successful cataract surgery depends on achieving a good capsulorhexis. During capsulorhexis, surgeons may face a challenging situation like a capsulorhexis radial tear-out. A surgeon must learn to tackle the problem promptly without making the situation worse. Some other methods of rescuing the situation have been described using a capsulorhexis forceps. However, we believe our method is quicker, more effective and easier to manipulate as demonstrated on the EYESi surgical simulator and on a human eye. Acknowledgments: List acknowledgements and funding sources. We would like to thank Dr. Wael El Gendy, for video clip. Disclosures: describe potential conflicting interests or state We have nothing to disclose. References: 1. Brian C. Little, Jennifer H. Smith, Mark Packer. J Cataract Refract Surg 2006; 32:1420 1422, Issue-9. 2. Neuhann T. Theorie und Operationstechnik der Kapsulorhexis. Klin Monatsbl Augenheilkd. 1987; 1990: 542-545. 3. Gimbel HV, Neuhann T. Development, advantages and methods of the continuous circular capsulorhexis technique. J Cataract Refract Surg. 1990; 16: 31-37. 4. Gimbel HV, Neuhann T. Continuous curvilinear capsulorhexis. (letter) J Cataract Refract Sur. 1991; 17: 110-111.

Capsulorhexis is an important step in phacoemulsification surgery. A surgeon creates a continous curvilinear tear on the anterior lens capsule by controlling the tearing vector forces. A peripherally extended tear is a serious complication. This video demonstrates a novel technique of rescuing capsular radial tear out using a cystotome.

Eine neuartige Technik der Rettung Capsulorhexis Radial Tear-out mit einem Cystotome

Part 1 : Purpose:   To demonstrate a capsulorhexis radial tear out rescue technique using a cystotome on a virtual reality cataract surgery simulator and ...

Guidelines for Elective Pediatric Fiberoptic Intubation

Fiberoptic intubation in pediatric patients is often required especially in difficult airways of syndromic patients i.e. Pierre Robin Syndrome. Small babies will desaturate very quickly if ventilation is interrupted mainly to high metabolic rate. We describe guidelines to perform a safe fiberoptic intubation while maintaining spontaneous breathing throughout the procedure. Steps requiring the use of propofol pump, fentanyl, glycopyrrolate, red rubber catheter, metal insuflation hook, afrin, lubricant and lidocaine spray are shown.

We describe guidelines to perform a safe and efficient elective fiberoptic intubation in pediatric patients while maintaining spontaneous ventilation.

Richtlinien für die Wahlfächer Pediatric Fiberoptische Intubation

Fiberoptic intubation in pediatric patients is often required especially in difficult airways of syndromic patients i.e. Pierre Robin Syndrome. Small ...

A Simple Method of Mouse Lung Intubation

A simple procedure to intubate mice for pulmonary function measurements would have several advantages in longitudinal studies with limited numbers or expensive animal. One of the reasons that this is not done more routinely is that it is relatively difficult, despite there being several published studies that describe ways to achieve it. In this paper we demonstrate a procedure that eliminates one of the major hurdles associated with this intubation, that of visualizing the trachea during the entire time of intubation. The approach uses a 0.5 mm fiberoptic light source that serves as an introducer to direct the intubation cannula into the mouse trachea. We show that it is possible to use this procedure to measure lung mechanics in individual mice over a time course of at least several weeks. The technique can be set up with relatively little expense and expertise, and it can be routinely accomplished with relatively little training. This should make it possible for any laboratory to routinely carry out this intubation, thereby allowing longitudinal studies in individual mice, thereby minimizing the number of mice needed and increasing the statistical power by using each mouse as its own control.

This paper describes a striaghforward and efficient method of intubating mice for pulmonary function measurements or pulmonary instillation, that allows the mice to recover and be studied at later times. The procedure involves an inexpensive fiberoptic light source that directly illuminates the trachea.

Eine einfache Methode der Maus Lung Intubation

A  simple procedure to intubate mice for pulmonary function measurements would  have several advantages in longitudinal studies with limited numbers or  ...

A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders

Differentiation and activation of osteoclasts play a key role in the development of musculoskeletal diseases as these cells are primarily involved in bone resorption. Osteoclasts can be generated in vitro from monocyte/macrophage precursor cells in the presence of certain cytokines, which promote survival and differentiation. Here, both in vivo and in vitro techniques are demonstrated, which allow scientists to study different cytokine contributions towards osteoclast differentiation, signaling, and activation. The minicircle DNA delivery gene transfer system provides an alternative method to establish an osteoporosis-related model is particularly useful to study the efficacy of various pharmacological inhibitors in vivo. Similarly, in vitro culturing protocols for producing osteoclasts from human precursor cells in the presence of specific cytokines enables scientists to study osteoclastogenesis in human cells for translational applications. Combined, these techniques have the potential to accelerate drug discovery efforts for osteoclast-specific targeted therapeutics, which may benefit millions of osteoporosis and arthritis patients worldwide.

A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders

Differentiation of precursor cells into osteoclasts is regulated by cytokines and growth factors. Here, a novel gene transfer technique for differentiation of osteoclasts in vivo and cell culture protocols for differentiating precursor cells into osteoclasts in vitro as a method to study the effects of cytokines on osteoclastogenesis are described.

A Novel<em&gt; In vivo</em&gt; Gentransfer-Technik und<em&gt; In-vitro-</em&gt; Zellbasierte Assays für das Studium der Knochenverlust in Skeletterkrankungen

Differentiation and activation of osteoclasts play a key role in the development of musculoskeletal diseases as these cells are primarily involved in bone ...

Intubation-mediated Intratracheal (IMIT) Instillation: A Noninvasive, Lung-specific Delivery System

Respiratory disease studies typically involve the use of murine models as surrogate systems. However, there are significant physiologic differences between the murine and human respiratory systems, especially in their upper respiratory tracts (URT). In some models, these differences in the murine nasal cavity can have a significant impact on disease progression and presentation in the lower respiratory tract (LRT) when using intranasal instillation techniques, potentially limiting the usefulness of the mouse model to study these diseases. For these reasons, it would be advantageous to develop a technique to instill bacteria directly into the mouse lungs in order to study LRT disease in the absence of involvement of the URT. We have termed this lung specific delivery technique intubation-mediated intratracheal (IMIT) instillation. This noninvasive technique minimizes the potential for instillation into the bloodstream, which can occur during more invasive traditional surgical intratracheal infection approaches, and limits the possibility of incidental digestive tract delivery. IMIT is a two-step process in which mice are first intubated, with an intermediate step to ensure correct catheter placement into the trachea, followed by insertion of a blunt needle into the catheter to mediate direct delivery of bacteria into the lung. This approach facilitates a &#62;98% efficacy of delivery into the lungs with excellent distribution of reagent throughout the lung. Thus, IMIT represents a novel approach to study LRT disease and therapeutic delivery directly into the lung, improving upon the ability to use mice as surrogates to study human respiratory disease. Furthermore, the accuracy and reproducibility of this delivery system also makes it amenable to Good Laboratory Practice Standards (GLPS), as well as delivery of a wide range of reagents which require high efficiency delivery to the lung.

Intubation-mediated Intratracheal IMIT Instillation: A Noninvasive, Lung-specific Delivery System

Intubation-mediated intratracheal (IMIT) instillation of reagents is an excellent, noninvasive method for studying respiratory disease, as well as a method for instilling therapeutic reagents directly into the lung. It is a rapid and highly reproducible method which is suitable for preclinical testing.

Intubation vermittelte Intratracheale (IMIT) Instillation: eine nichtinvasive, lungenspezifischen Delivery System

Respiratory disease studies typically involve the use of murine models as surrogate systems. However, there are significant physiologic differences ...

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

A patient&#39;s willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can jeopardize their spontaneous breathing, topical anesthesia of the airway is a popular technique. The spray-as-you-go technique represents one of the simplest opportunities to anesthetize the airway mucosa. The application of local anesthetic through the working channel of the flexible endoscope is a widespread practice for anesthetists as well as pulmonologists. There is neither need for additional devices nor special training as a pre-requisite to perform this technique. However, a known clinical problem is the coughing and gagging reflex that may occur when the liquid anesthetic strikes the airway mucosa and other sensitive structures like the vocal cords. This can be avoided by the use of oxygen applied through the working channel with the aim of fogging the local anesthetic into finer particles. Furthermore, the oxygen flow provides a higher oxygen supply and contributes to a better view, dispersing mucus secretions and blood away from the lens. Using an atomizer with a high oxygen flow of 10 L/min we maximized these benefits, caused less coughing and had more satisfied and therefore cooperative patients. Possible, but very rare complications of using oxygen flow including gastric insufflation, organ rupture or barotrauma did not arise. We attribute the complication-free use of high oxygen flow to the design of the set, which permits flow and pressure release.

The topical anesthetic lidocaine was atomized using a high oxygen flow through the working channel of a flexible intubating endoscope to achieve topical airway anesthesia for awake endotracheal intubation. We prefer this modified spray-as-you-go technique for endoscopic intubation to classical bolus application because of higher patient satisfaction and better compliance.

Topical Airway Anästhesie für Wach-endoskopische Intubation Mit der Spray-as-you-go-Technik mit hoher Sauerstoff-Flow

A patient&#39;s willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can ...

Repeated Measurement of Respiratory Muscle Activity and Ventilation in Mouse Models of Neuromuscular Disease

Accessory respiratory muscles help to maintain ventilation when diaphragm function is impaired. The following protocol describes a method for repeated measurements over weeks or months of accessory respiratory muscle activity while simultaneously measuring ventilation in a non-anesthetized, freely behaving mouse. The technique includes the surgical implantation of a radio transmitter and the insertion of electrode leads into the scalene and trapezius muscles to measure the electromyogram activity of these inspiratory muscles. Ventilation is measured by whole-body plethysmography, and animal movement is assessed by video and is synchronized with electromyogram activity. Measurements of muscle activity and ventilation in a mouse model of amyotrophic lateral sclerosis are presented to show how this tool can be used to investigate how respiratory muscle activity changes over time and to assess the impact of muscle activity on ventilation. The described methods can easily be adapted to measure the activity of other muscles or to assess accessory respiratory muscle activity in additional mouse models of disease or injury.

This paper introduces a method for repeated measurements of ventilation and respiratory muscle activity in a freely behaving amyotrophic lateral sclerosis (ALS) mouse model throughout disease progression with whole-body plethysmography and electromyography via an implanted telemetry device.

Wiederholte Messung der Atemmuskelaktivität und Ventilation in Mausmodellen von neuromuskulären Erkrankungen

Accessory respiratory muscles help to maintain ventilation when diaphragm function is impaired. The following protocol describes a method for repeated ...

Minimally Invasive Muscle Embedding (MIME) - A Novel Experimental Technique to Facilitate Donor-Cell-Mediated Myogenesis

Skeletal muscle possesses regenerative capacity due to tissue-resident, muscle-fiber-generating (myogenic) satellite cells (SCs), which can form new muscle fibers under the right conditions. Although SCs can be harvested from muscle tissue and cultured in vitro, the resulting myoblast cells are not very effective in promoting myogenesis when transplanted into host muscle. Surgically exposing the host muscle and grafting segments of donor muscle tissue, or the isolated muscle fibers with their SCs onto host muscle, promotes better myogenesis compared to myoblast transplantation. We have developed a novel technique that we call Minimally Invasive Muscle Embedding (MIME). MIME involves passing a surgical needle through the host muscle, drawing a piece of donor muscle tissue through the needle track, and then leaving the donor tissue embedded in the host muscle so that it may act as a source of SCs for the host muscle. Here we describe in detail the steps involved in performing MIME in an immunodeficient mouse model that expresses a green fluorescent protein (GFP) in all of its cells. Immunodeficiency in the host mouse reduces the risk of immune rejection of the donor tissue, and GFP expression enables easy identification of the host muscle fibers (GFP+) and donor-cell-derived muscle fibers (GFP-). Our pilot data suggest that MIME can be used to implant an extensor digitorum longus (EDL) muscle from a donor mouse into the tibialis anterior (TA) muscle of a host mouse. Our data also suggest that when a myotoxin (barium chloride, BaCl2) is injected into the host muscle after MIME, there is evidence of donor-cell-derived myogenesis in the host muscle, with approximately 5%, 26%, 26% and 43% of the fibers in a single host TA muscle showing no host contribution, minimal host contribution, moderate host contribution, and maximal host contribution, respectively.

Minimally Invasive Muscle Embedding MIME - A Novel Experimental Technique to Facilitate Donor-Cell-Mediated Myogenesis

We describe a novel experimental technique that we call Minimally Invasive Muscle Embedding (MIME), which is based on the evidence that skeletal muscle tissue contains viable myogenic cells that can facilitate donor-cell-mediated myogenesis when implanted into a host muscle.

Minimal-Invasive Muskel einbetten (MIME) - eine neuartige experimentelle Technik, Spender-Zell-vermittelten Myogenesis zu erleichtern

Skeletal muscle possesses regenerative capacity due to tissue-resident, muscle-fiber-generating (myogenic) satellite cells (SCs), which can form new ...

A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep learning curve. The introduction of the cuff technique for anastomosis of the portal vein (PV) and infrahepatic vena cava (IHVC) has significantly simplified the transplant procedure in rats. However, due to the short anterior wall of the recipients' suprahepatic vena cava (SHVC), the cuff technique is very difficult to use for the reconstruction of the SHVC. Most researchers in this field still use the hand-suture technique for SHVC reconstruction, which makes it the bottleneck step in rat orthotopic liver transplantation. The magnetic anastomosis technique (i.e., magnamosis) is a method of connecting two vessels using the attractive force between two magnets. Our recent study has shown that the magnetic anastomosis technique is superior to the hand-suture technique for SHVC reconstruction in rats. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using the novel magnetic anastomosis technique. In this model, the reconstruction of the PV and IHVC was performed by the standard cuff technique, while the reconstruction of the bile duct (BD) was performed by a stent technique. The hepatic re-arterialization was not performed. The magnetic anastomosis technique made SHVC reconstruction much easier and significantly shortened the anphepatic phase. After a reasonable learning curve, even researchers without advanced microsurgical skills can produce reliable and reproducible results using this rat model of OLT.

The reconstruction of the suprahepatic vena cava (SHVC) remains a difficult step in rat orthotopic liver transplantation. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using a novel magnetic anastomosis technique.

Einem Rattenmodell der orthotopen Lebertransplantation mit einer neuartigen magnetischen Anastomose-Technik für Suprahepatic Vena Cava Wiederaufbau

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep ...