Microsurgical vascular anastomosis can be intense and technically demanding. Therefore, numerous techniques have been described to simplify the technique, increase efficiency, and improve outcomes. The authors present their experience with three patients that underwent microsurgical vascular anastomosis utilizing the nitinol U-clip. This sutureless penetrating clip is applied in an interrupted fashion, thus, eliminating knot tying. The authors report that all three cases were free from microvascular complications and were performed rapidly with this device.
The use of alternative techniques to perform suture anastomosis in microvascular surgery is not a new concept and various clips and devices have been used successfully in free-tissue reconstructions. At this time, no sutureless method of microvascular anastomosis has gained widespread appeal and the simple interrupted suture remains the gold standard. This technique utilizing nitinol U-clips, however, holds the potential for rapid, reproducible sutureless microvascular anastomoses if additional, larger series reproduce its efficacy and safety. Additionally, the surgical technique may gain popularity as it is very similar to the conventional suture microanastomosis, lending itself to comparatively decreased learning curves and suitability for training programs.