Use of a novel penetrating, sutureless anastomotic device in arterial microvascular anastomoses

The advent of microsurgery and microvascular anastomosis has helped to alter the treatment of many traumatic defects as well as revolutionize the reconstructive options after extirpative surgery. These procedures, however, continue to be technically demanding and intensive. In addition, increased ischemia and operative times are known to raise complications in microsurgery, particularly in older patients. The nitinol U-clip (Medtronic, Inc., Minneapolis, MN) is a new penetrating clip applied in an interrupted fashion that eliminates knot tying and decreases operative time. This technology holds the potential for rapid, reproducible sutureless microvascular anastomoses. In addition, the surgical technique is very similar to conventional suture microanastomosis, lending itself to comparatively decreased learning curves and suitability for training programs. We present three consecutive cases of successful microsurgical anastomoses using this technology.