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Journal of Neurology and Neuroscience

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Clinical Images - (2017) Volume 8, Issue 6

Preparation and Realization of Anastomosis in the Placenta for Vascular Neurosurgeon Training

Soto-Granados Oliver, González-Echeverría Kléber Eduardo*, Soto-Granados Fernando, Sánchez-Haz Néstor and Chaddad-Neto Feres

Laboratory of Neuro-surgical Techniques, Federal University of Sao Paulo, Brazil

*Corresponding Author:

González-Echeverría Kléber Eduardo
Laboratory of Neuro-surgical Techniques, Federal University of São Paulo, Brazil.
Tel: +5511971785210
E-mail: [email protected]

Received Date: October 15, 2017; Accepted Date: October 25, 2017; Published Date: October 31, 2017

Citation: Soto-Granados O, González-Echeverría KE, Soto-Granados F, Sánchez-Haz N, Chaddad-Neto F (2017) Preparation and Realization of Anastomosis in the Placenta for Vascular Neurosurgeon Training. J Neurol Neurosci Vol. 8 No: 6:i233. doi: 10.21767/2171-6625.1000i233

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Abstract

To know, the way of preparing the placenta and the dissection of this to perform anastomosis. By means of newly obtained placentas, this exhaustive lavage is performed, a 4fr feeding catheter is placed, one in each artery and one in vein, is made to wash blood vessels with water and then irrigate red paint diluted with diluent, to color the artery, the same procedure is repeated in the vein but blue color for the differentiation of the vessels. These catheters are in continuous color irrigation. Later proceed to microscope time, the removal of the arachnoid simulation, circumferential dissection of arteries and veins of the placenta. Subsequently an artery-artery anastomosis and an artery-vein are performed.

Clinical Image

To know, the way of preparing the placenta and the dissection of this to perform anastomosis.

By means of newly obtained placentas, this exhaustive lavage is performed, a 4fr feeding catheter is placed, one in each artery and one in vein, is made to wash blood vessels with water and then irrigate red paint diluted with diluent, to color the artery, the same procedure is repeated in the vein but blue color for the differentiation of the vessels. These catheters are in continuous color irrigation. Later proceed to microscope time, the removal of the arachnoid, dissection of arteries and veins of the placenta. Subsequently an arteryartery anastomosis and an artery-vein are performed [1-3].

Two placentas were used in September 2017. The dissection was performed under the supervision of Dr. Feres Chaddad Neto, Vascular Neurosurgeon and Head of the Microsurgical Neuro Techniques Laboratory of the Federal University of Sao Paulo – Brazil (Figure 1).

jneuro-colors-preparation

Figure 1: (1) Diluent and colors for preparation of the placenta. (2) Identification of arachnoids in the placenta. (3) Removal of arachnoids and identification of arteries and veins. (3) Dissection of arteries. (5,6) Perform anastomosis of arteries with nylon number 7-0. (7,8) Vein - artery anastomosis.

The material used for the dissections were:

1. A bucket.

2. Carl Zeiss OPMI peak f 170 microscope.

3. Dissecting tweezers with and without teeth.

4. Micro scissors.

5. Scalpel sheet number 11.

6. 2 straight clips (Yasargil).

7. 7-0 nylon suture.

8. Camera: Brand Nikon 12x COOLPIX S6800 digital.

References

  1. Romero FR, Fernandes ST, Chaddad-Neto F, Ramos JG, De Campos JM, et al. (2008) Microsurgical techniques using human placenta. Arq Neuropsiquiatr 66: 876-878.
  2. Magaldi MO, Nicolato A, Godinho JV, Santos M, Prosdocimi A, et al. (2017) Human placenta aneurysm model for training neurosurgeons in vascular microsurgery. Operative Neurosurgery 10: 592-601. 
  3. De Oliveira MMR, Ferrarez CE, Ramos TM, Malheiros JA, Nicolato A, et al. (2017) Learning brain aneurysm microsurgical skills in a human placenta model: Predictive Validity. J Neurosurg 24: 1-7.