血管吻合における非利き手での運針 (hand-switch technique) の実行可能性の検討

抄録

　Successful microvascular anastomosis is crucial for achieving favorable outcomes in procedures such as free tissue transfer and digit replantation, and various microsurgical anastomotic techniques have been described. Most surgeons rely predominantly on their dominant hand for needle holder manipulation, but this approach may be challenging in certain clinical situations. Therefore, we developed the hand-switch technique. in which the needle holder is switched between the dominant and non-dominant hands during suturing. In this study, we aimed to describe this technique and evaluate its feasibility by using a chicken wing artery model under a tabletop microscope and comparing it with a conventional dominant-hand technique. End-to-end arterial anastomoses were performed on a chicken wing ulnar artery model using a conventional technique and the hand-switch technique, with 10 anastomoses in each group. Anastomosis time and quality were assessed using the medication adherence rating scale 10 (MARS 10) score. No statistically significant differences in anastomosis time or MARS 10 scores were observed between the two groups. The hand-switch technique did not compromise anastomotic quality compared with the conventional technique performed by an experienced microsurgeon. The hand-switch technique may be a feasible option for microvascular anastomosis under the present experimental conditions.