A realistic model for vasectomy reversal training using swine testicles

Purpose: To evaluate the viability of the porcine vas deferens as a realistic microsurgical training model for vasectomy reversal Methods: The model uses swine testicles (vas deferent), which are usually discarded in large street markets since they are not part of Brazilian cuisine. The spermatic cord was carefully dissected, and the vas deferens were isolated, measuring 10 cm in length. A paper quadrilateral with 5 cm2 was built to delimit the surgical training field. The objective of the model is to simulate only the microsurgical step when the vas deferens are already isolated. The parameters analyzed were: feasibility for reproducing the technique, patency before and after performing the vasovasostomy, cost of the model, ease of acquisition, ease of handling, execution time, and model reproducibility. Results: The simulator presented low cost. All models made were viable with a texture similar to human, with positive patency obtained in 100% of the procedures. The internal and external diameters of the vas deferens varied between 0.2-0.4 mm and 2-3 mm, respectively, with a mean length of 9 ± 1.2 cm. The total procedure time was 43.28 ± 3.22 minutes. Conclusions: The realistic model presented proved to be viable for carrying out vasectomy reversal training, due to its low cost, easy acquisition, and easy handling, and providing similar tissue characteristics to humans.

Microsurgical arterial anastomosis in young and adult rats: an evolutive and comparative study

Purpose: To evaluate the caliber of an arterial micro-anastomosis in the young growing animal using a continuous suture technique. Additionally, late morphological changes and blood flows distal to the anastomosis were evaluated. Methods: Seventy-four Wistar rats were submitted to laparotomy to access the aorta for blood flow measurement. The aorta was sectioned using microsurgery technique and an end-to-end anastomosis with continuous suture. After a period of six months to one year, the anastomosis was checked. Results: Regarding the size of the aortas, comparing the pre- and postoperative values, there was an increase of 13.33% in adult animals and 25% in young animals, without any difference in the blood flows. Conclusions: The arteries of young rats show signs of growth at the site of the anastomosis performed with continuous suture.

Comparison of three different strategies to treat sciatic nerve regeneration: an experimental study

Purpose: To compare the effect of vein conduit filled with adipose tissue stem cells (ASC) on peripheral nerve injury regeneration. Methods: We analyzed 30 male Wistar rats surgically submitted to a 5-mm gap on the sciatic nerve. Then, the animals were divided into three groups: nerve autografting (AG, n=10), autogenous inverted glycerol-conserved vein (VG, n=10), and autogenous inverted glycerol-conserved vein + ASC (VASCG, n=10). The study endpoints were neuromotor functional analysis, gastrocnemius muscle weight, and sciatic nerve graft histomorphometry analysis. In the histologic analysis, we added a control group (naïve nerve). Results: Regarding functional analysis (Walking tract- score), the findings at week 3 showed a difference between the AG and the VG (-96.6 vs. -59.6, p=0.01, respectively) and between the VG and the inverted vein + VASCG (-59.9 vs. -88.92, p=0.02). At week 12, this study showed a difference between the AG and the VG (-64.8 vs. -47.3, p=0.004, respectively), and also a difference between the VG and the VASCG (-47.3 vs. -57.4, p=0.02, respectively). There was no difference in the histomorphometry analysis (nerve diameter, Schwann cells counting). The gastrocnemius muscles on the intervention side were more atrophic when compared to the gastrocnemius muscles on the control side. Conclusions: Our results suggested better functional recovery in the inverted vein group when compared to control group, and inverted vein + ASC group.

Anatomical description of the extratemporal facial nerve under high-definition system: a microsurgical study in rats

Purpose: To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. Methods: Ten male Wistar rats (12­15 weeks old), without veterinary diseases, weighing 220­280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. Results: The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. Conclusions: The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.

Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery

ABSTRACT Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusions: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

A new anesthetic protocol to medullary nerve roots access in rats

ABSTRACT Purpose: To describe a new anesthetic protocol medullary and nerve roots access and in Rattus norvegicus. Methods: Seventy female Wistar rats (n=70) were used. The animals were randomly divided into two laminectomy groups: cervical (n=40) and thoracic (n=30). In cervical group, a right posterior hemilaminectomy was performed to access the nerve roots. In thoracic group, a laminectomy of the eighth thoracic vertebra was accomplished. Thirty-five rats (20 cervical and 15 thoracic) were submitted to old anesthetic protocol (ketamine 70 mg/kg plus xylazine 10 mg/kg); and the 35 other animals (20 cervical and 15 thoracic) were submitted to a new anesthetic protocol (ketamine 60 mg/kg,xylazine 8 mg/kg and fentanyl 0.03 mg/kg). Results: The time to complete induction was 4.15 ±1.20 minin ketamine, xylazine and fentanyl group, and it was 4.09 ±1.47 min in the ketamine and xylazine group. There was no correlation in the time required to perform the cervical laminectomy in the old anesthetic protocol. In all groups, the animals submitted to the old anesthetic protocol had a higher level of pain on the first and third postoperative days than the animals submitted to the new anesthetic protocol. Conclusions: The new anesthetic protocol reduces the surgical time, allows better maintenance of the anesthetic plan, and brings more satisfactory postoperative recovery.

A microsurgical technique for catheter insertion in the rat femoral artery

Purpose: To modify a surgical catheterization method using the bent needle introducer in small animals. Methods: Eight-week-old male Lewis rats were used in the study. A needle introducer was created by bending a 21G injection needle at 45°. The bent needle introducer was used for catheter insertion into the left femoral artery of the rats under anesthesia. As a control, a catheter was directly inserted into the blood vessel without the introducer. The insertion time of each method was measured. Blood pressure and heart rate were measured 24 h after catheter insertion using the telemetry system. Results: Using the introducer, the catheter was successfully inserted within a short time in all rats. Without the introducer, a longer duration was required for catheter insertion. The frequency of the insertion with no catheter-based errors with the introducer tended to be higher than that without the introducer. The mean arterial pressure and heart rate 24 h after catheter insertion in each group were almost the same. Conclusions: We developed a surgical catheterization method using the introducer in small animals. This could potentially reduce the frequency of the insertion with catheter-based errors and insertion time.(AU)

Stem cells in end-to-side neurorrhaphy: experimental study in rats

Purpose: To evaluate the influence of mesenchymal stem cells from adipose tissue in the end-to-side neurorrhaphy, focusing in the nerve regeneration and the muscle reinnervation in acute trauma. Methods: 140 animals were randomly divided in seven groups: control, denervated, end-to-side neurorrhaphy between distal stump of common peroneal nerve and tibial nerve (ESN), ESN wrapped in fascia, ESN wrapped in fascia and platelet gel, ESN wrapped in platelet gel, ESN wrapped in fascia and platelet gel within stem cells (without culture) removed from the adipose tissue. Mass measurements of the animal and of cranial tibial muscles, electromyography, walking track analysis tests and histological examinations of the nerves and muscles after 180 days was performed. Results: In the groups where the ESN was performed, the results were always better when compared to the denervated group, showing reinnervation in all ESN groups. The most sensitive methods were walking track and histological analysis. Only the group with stem cells showed values similar to the control group, as well as the functional indices of peroneal nerve and the number of nerve fibers in the peroneal nerve. Conclusions: Stem cells were effective in ESN according with the functional index of the peroneal nerve, evaluated by walking track analysis and the number of nerve fibers in the peroneal nerve.(AU)

Experiences with basic microsurgical training programs and skill assessment methods at the University of Debrecen, Hungary

During the past decades microsurgical training programs together with skill assessment methods had been developing intensively worldwide. Concerning the teaching of basic techniques at various levels, we aimed to summarize the education program types and experiences at our department, in order to define the way of continuity. All in the hope that this summary might contain useful information for other educators as well. About 50 years ago, in the late 1960s, microsurgical basic education had been established in Debrecen. Since the 1990s multilevel education programs have been developed, starting in undergraduate years up to the postgraduate training, residency and continuous medical education programs. In the last three decades about 2,300 participants completed courses, including over 470 residents. The ones who already succeeded microsurgical course as medical students, during residency program could reach better results and skill development. Concluding thoughts, the traditional methods and special experiences are highly important in microsurgical education. The necessary duration and individual training approach are emphasized. Standardization (self and international), comparability, accessibility, providing milestones of microsurgical skills are key factors. Proper feedback and skill assessment (experiences, internationally recognized scores, or combinations) are indispensable, but have to be fitted to the characteristic elements of the course.(AU)

New trends in translational microsurgery

Technological advances such as optical instruments and surgical tools have enabled the considerable contributions of microsurgery to surgical therapies. Accordingly, surgical therapeutics has provided the latest information across a wide range of medical specialties, including immunology and pharmacology, despite specialization according to organs and organ systems. The International Society for Experimental Microsurgery, an academic organization, has utilized experimental microsurgery technology in the identification of curative concepts for diseases that remain difficult to treat. For this publication to mark the 32nd anniversary of the Brazilian Surgical Society, I introduced the following types of technology related to the further development of microsurgical technological innovations in the future: high-resolution three-dimensional (3D) video and touch-sensitive microsurgery robots.(AU)

Impacto do grau de uveíte em diferentes tipos de úlceras de córneas em cães submetidos ao enxerto pediculado de conjuntiva bulbar - 34 casos / Impact of uveitis score on different types of corneal ulcers in dogs subjected to the bulbar conjunctival pedicle graft - 34 cases

O presente trabalho objetivou avaliar os resultados de 34 olhos submetidos ao enxerto conjuntival pediculado (ECP) em ceratites ulcerativas profundas (n=5), em ceratites ulcerativas com colagenólise (n=2), descemetocele (n=7), perfuração corneal (n=15) e prolapso de íris (n=5). Os impactos do grau de uveíte e da integridade da córnea foram correlacionados com presença e ausência de visão por tabelas de contingência. Raças braquicefálicas foram acometidas em 91,11% dos casos. O número de córneas consideradas perfuradas [20/34 (58,82%)] foi maior que o de córneas íntegras [14/34 (41,17%)]. Ao 50º dia de pós-operatório, o número de olhos visuais que apresentavam córneas íntegras previamente às cirurgias (n=13) não diferiu significativamente dos olhos com córneas perfuradas (n=12) (P=0,05). Avaliações relativas ao grau de uveíte, revelaram que a metade dos casos foi considerada severa [17/34 (50%)] e na outra metade as uveítes foram consideradas discretas. Dos 17 casos que apresentaram uveíte severa, oito recuperaram a visão. Já nos 17 olhos onde a uveíte foi considerada leve, 15 mantiveram a visão ao final do período de avaliação. Apesar de a integridade da córnea não se correlacionar com a severidade da uveíte (P=0,48), constatou-se que o número de olhos visuais com uveíte discreta foi significativamente maior que os olhos com uveíte severa (P=0,006). Neste estudo, a taxa geral de sucesso visual após ECP foi de 73,52% e a integridade da córnea não exerceu impacto significativo sobre a manutenção da visão. Todavia, olhos acometidos por uveítes severas apresentaram menor chance de recuperar a visão.(AU)

The present study aimed to evaluate the results of 34 eyes of dogs presenting deep corneal ulcer (n=5), colagenolytic corneal ulcer (n=2), descemetocele (n=7), corneal perforation (n=15), and iris prolapse (n=5) that were corrected by the bulbar conjuntival pedicle graft (CPG). The uveitis score and the corneal integrity were correlated with the presence or absence of vision by contingency tables. Brachycephalic breeds accounted for 91.11% of all cases. The number of perforated corneas [20/34 (58.82%)] were higher than the non-perforated ones [14/34 (41.17%)]. At post-operative day 50, the number of visual eyes with non-perforated corneas before surgery (n=13) did not differ significantly from the eyes with perforated corneas (n=12) (P = 0.05). In half of the cases, uveitis score was considered severe [17/34 (50%)], and in the other half, mild. Eight out of 17 eyes classified with severe uveitis regained vision. In 17 eyes where uveitis score was considered mild, 16 regained vision at the end of the study. Although corneal integrity was non-correlated with the uveitis score (P = 0.48), the number of visual eyes scored with mild uveitis were significantly larger than the eyes with severe uveitis (P = 0.006). In this study, the overall success visual rate after CPG was 73,52% % and the corneal integrity did not play an important role regarding maintenance of vision. However, eyes presenting severe uveitis score had less chance to regain vision.(AU)

Impacto do grau de uveíte em diferentes tipos de úlceras de córneas em cães submetidos ao enxerto pediculado de conjuntiva bulbar - 34 casos / Impact of uveitis score on different types of corneal ulcers in dogs subjected to the bulbar conjunctival pedicle graft - 34 cases

O presente trabalho objetivou avaliar os resultados de 34 olhos submetidos ao enxerto conjuntival pediculado (ECP) em ceratites ulcerativas profundas (n=5), em ceratites ulcerativas com colagenólise (n=2), descemetocele (n=7), perfuração corneal (n=15) e prolapso de íris (n=5). Os impactos do grau de uveíte e da integridade da córnea foram correlacionados com presença e ausência de visão por tabelas de contingência. Raças braquicefálicas foram acometidas em 91,11% dos casos. O número de córneas consideradas perfuradas [20/34 (58,82%)] foi maior que o de córneas íntegras [14/34 (41,17%)]. Ao 50º dia de pós-operatório, o número de olhos visuais que apresentavam córneas íntegras previamente às cirurgias (n=13) não diferiu significativamente dos olhos com córneas perfuradas (n=12) (P=0,05). Avaliações relativas ao grau de uveíte, revelaram que a metade dos casos foi considerada severa [17/34 (50%)] e na outra metade as uveítes foram consideradas discretas. Dos 17 casos que apresentaram uveíte severa, oito recuperaram a visão. Já nos 17 olhos onde a uveíte foi considerada leve, 15 mantiveram a visão ao final do período de avaliação. Apesar de a integridade da córnea não se correlacionar com a severidade da uveíte (P=0,48), constatou-se que o número de olhos visuais com uveíte discreta foi significativamente maior que os olhos com uveíte severa (P=0,006). Neste estudo, a taxa geral de sucesso visual após ECP foi de 73,52% e a integridade da córnea não exerceu impacto significativo sobre a manutenção da visão. Todavia, olhos acometidos por uveítes severas apresentaram menor chance de recuperar a visão.(AU)

The present study aimed to evaluate the results of 34 eyes of dogs presenting deep corneal ulcer (n=5), colagenolytic corneal ulcer (n=2), descemetocele (n=7), corneal perforation (n=15), and iris prolapse (n=5) that were corrected by the bulbar conjuntival pedicle graft (CPG). The uveitis score and the corneal integrity were correlated with the presence or absence of vision by contingency tables. Brachycephalic breeds accounted for 91.11% of all cases. The number of perforated corneas [20/34 (58.82%)] were higher than the non-perforated ones [14/34 (41.17%)]. At post-operative day 50, the number of visual eyes with non-perforated corneas before surgery (n=13) did not differ significantly from the eyes with perforated corneas (n=12) (P = 0.05). In half of the cases, uveitis score was considered severe [17/34 (50%)], and in the other half, mild. Eight out of 17 eyes classified with severe uveitis regained vision. In 17 eyes where uveitis score was considered mild, 16 regained vision at the end of the study. Although corneal integrity was non-correlated with the uveitis score (P = 0.48), the number of visual eyes scored with mild uveitis were significantly larger than the eyes with severe uveitis (P = 0.006). In this study, the overall success visual rate after CPG was 73,52% % and the corneal integrity did not play an important role regarding maintenance of vision. However, eyes presenting severe uveitis score had less chance to regain vision.(AU)

A non-living, effective model for microvascular training

Purpose: To introduce a nonliving microvascular training model based on vessels diameter and feasibility. Methods: We dissected ten oxen tongues, and divided the pedicles into three-thirds: proximal, middle and distal. We measured the external vessels diameter in all regions. We performed a descriptive statistical analysis. Three students (two beginner level and one intermediate level) performed this training. We evaluated the confidence, according Likert scale. Results: We dissected all oxen tongues, each tongue showed two parallel pedicles. Each pedicle was located at 1.5 - 2.0 cm from the midline. Proximal median artery and vein diameter were 3.9 ± 0.7, and 5.04 ± 1.44mm, respectively. In the middle third, the mean artery diameter was 3.3 ± 0.4mm, and the vein diameter was 3.5 ± 0.9mm. The distal third showed a mean artery diameter of 2.0 ± 0.42mm, and a vein diameter of 2.4 ± 0.82mm. The students performed ten anastomoses. This study showed a higher confidence level (CL) (p=0.03) than the pre training CL assessment. Conclusion: This study suggested a feasible non-animal model for microsurgical training process for beginners and intermediate trainees.(AU)

Continuous versus interrupted suture technique in microvascular anastomosis in rats

Purpose: To compare the continuous and interrupted suture technique on femoral artery on rats after vessel repair and 14 days after. Methods: Twenty rats were operated randomly divided into two group matched according to the suture technique used: interrupted or continuous. We performed a femoral anastomosis on the right femoral artery. We analyzed weight, arterial caliber, anastomosis time and patency after vessel repair and 14 days after. Results: There was no significant difference between groups in the weight (p=0.64), diameter of the femoral artery (p=0.95) and patency (p=1.00). The time spent in the anastomosis was 451 seconds in the continuous group and 718 seconds in the interrupted group, presenting significant difference (p 0.01). Conclusion: The continuous suture technique shows a similar patency rates than interrupted technique, however with a shorter time to perform the anastomosis.(AU)

End-to-side versus end-to-end neurorrhaphy at the peroneal nerve in rats

Purpose: To evaluate three different kinds of neurorrhaphy of the peroneal nerve. Methods: Eigthy rats were divided into 5 groups. Control: nerve had no intervention. End-to-end (EE): nerve was cut and elongated with a nerve graft with two end-to-end neurorrhaphies. End-to-side (ES): nerve was cut and sutured to the graft with at the lateral side of the nerve. Side-to-end (SE): the nerve was cut and sutured to the graft with end-to-end neurorrhaphy. Denervated: nerve was cut and both endings were buried into the muscle. The evaluation was done by walking track analysis, electrophysiology, body mass, cranial tibial muscle mass, nerve and muscle fibers morphometry. Results: The EE, ES and SE have the same potential of reinnervation. Conclusion: There is no functional or histological difference between these different types of neurorrhaphy.(AU)

Translational microsurgery. A new platform for transplantation research

PURPOSE:Clinical microsurgery has been introduced in many fields, while experimental microsurgery has the cross-disciplinary features of the sciences and techniques for growth of medicine, pharmacology, veterinary, engineering etc. Training protocol, proposing a new name as Translational Microsurgery, was introduced.METHODS:Reconstructive skills of hepatic artery in pediatric living donor liver transplantation were summarized. Ex vivo training protocol using artificial blood vessel for surgeons was proposed.RESULTS:Clinical microsurgery requires anastomosis with delicate arteries and limited field of view. Our training protocol revealed that the relation between the score and speed was seen, while not all the surgeons with enough experience got high score. This training led to muster clinical skills and to apply excellent experimental works.CONCLUSIONS:Our microsurgical training protocol has been planned from the points of clinical setting. Training for vascular anastomosis led to rodent transplantation models. These models were used for immunology and immunosuppressant research. Microsurgical techniques led to master catheter technique and to inject various drugs or gene vectors.(AU)

Ureterorrafia microcirúrgica: consolidação da técnica

As obstruções ureterais felinas têm apresentado uma crescente incidência na prática clínica veterinária e podem ter o diagnóstico e tratamento complexos. Vários tratamentos cirúrgicos têm sido descritos para o alívio das obstruções ureterais felinas ao longo dos anos, e, apesar de a ureterotomia microcirúrgica ser apontada como um dos tratamentos mais eficazes, esta ainda está associada a altas taxas de complicações pós-operatórias e de mortalidade. Isto ocorre devido à escassez de pesquisas que correlacionem o pequeno diâmetro ureteral aos calibres dos fios de sutura mais adequados e materiais que causem menor reação tecidual, evitando complicações pós-operatórias como extravasamento urinário, fibrose e estenose. O objetivo é estabelecer o material e o diâmetro do fio de sutura mais adequado para a realização da ureterorrafia microcirúrgica. Através de comparações por meio de exames ultrassonográficos em dois tempos, além de avaliações macroscópicas e microscópicas, foi possível observar que os fios de sutura com calibre 10-0 causam menores alterações renais e ureterais no local da sutura e que o material náilon é eficaz para este procedimento mesmo se tratando de um fio inabsorvível em trato urinário. Nos calibres mais grosseiros como 6-0 e 8-0, os melhores resultados estão associados ao fio absorvível. Conclui-se que a utilização de fios mais finos, acoplados a agulhas atraumáticas e utilizando magnificação cirúrgica adequada possibilitam uma sutura ureteral mais precisa, reduzindo o dano tecidual e complicações associadas ao procedimento cirúrgico.

Feline ureteral obstructions have shown an increasing incidence in veterinary clinical practice and can have complex diagnosis and treatment. Several surgical treatments have been described for the relief of feline ureteral obstructions over the years and although microsurgical ureterotomy is considered one of the most effective treatments, it is still associated with high rates of postoperative complications and mortality. This is due to the scarcity of research that correlates the small ureteral diameter to the gauges of the most appropriate sutures and materials that cause less tissue reaction, avoiding postoperative complications such as urinary leakage, fibrosis and stenosis. The objective is to establish the material and the diameter of the most appropriate suture for performing microsurgical ureterorrhaphy. Through comparisons by means of two-stage ultrasound examinations, in addition to macroscopic and microscopic evaluations, it was possible to observe that 10-0 gauge sutures cause less renal and ureteral changes at the suture site and that the nylon material is effective for this procedure even if it is an absorbable thread in the urinary tract. In the coarsest calibers like 6-0 and 8-0, the best results are associated with the absorbable thread. It is concluded that the use of thinner threads, coupled with atraumatic needles and using appropriate surgical magnification allow a more accurate ureteral suture, reducing tissue damage and complications associated with the surgical procedure.

Microsurgical training model with nonliving swine head. Alternative for neurosurgical education

This paper proposes a practical model of microneurosurgical training using a nonliving swine head. Fresh porcine heads were obtained from butchery and dissected at our Laboratory of Microsurgery. Brain and skull base surgery were trained under microscopic magnification. RESULTS: Several neurosurgical procedures could be simulated in the nonliving pig model, including transcallosal approach to the lateral ventricle, lateral sulcus and middle fossa dissection, and posterior fossa surgery. The swine model perfectly simulates standard microneurosurgical procedures, and is a useful tool for developing and refining surgical skills.(AU)

A modified microsurgical model for end-to-side selective portacaval shunt in the rat: intraoperative microcirculatory investigations

PURPOSE: To investigate the intraoperative microcirculatory changes of the affected organs (small bowel, liver and kidney) during the making of a modified selective portacaval (PC) shunt. METHODS: On ten anaesthetized Sprague-Dawley rats the selective end-to-side mesocaval anastomosis was performed, where only the rostral mesenteric vein is utilized and the portal vein with the splenic vein are left intact. Morphometric and microcirculatory investigations using a LDF device determining flux units (BFU) were carried out. RESULTS: After completing the shunts the microcirculatory flux values did not recover in the same manner on the surface of the small intestine, the liver or the kidney. BFU values showed deterioration in the small intestine and in the liver (p<0.001). During the reperfusion the BFU values improved, but not in the same manner. The small intestine values left behind the kidney and liver data. CONCLUSIONS: Technically, the advantages of the models include the selective characteristic, the mesocaval localization and the relatively easy access to those vessels. However, its major disadvantage is the time needed for positioning the vessels without coiling or definitive stretching. Intraoperative LDF may provide useful data on the microcirculatory affection of the organs suffering from hypoperfusion or ischemia during creating the shunts.(AU)

MODELO EXPERIMENTAL DE INFECÇÃO URINÁRIA COM IMPLANTE INTRAVESICAL EM CAMUNDONGOS (MUS MUSCULUS)

O objetivo deste trabalho foi criar um modelo experimental que possibilite a introdução de implante com ou sem agente patogênico contendo no lúmen da vesícula urinária em camundongos (Mus musculus). Foram utilizados 42 camundongos (Mus musculus) Balb/c isogênicos, fêmeas, com oito semanas de idade, peso médio de 15,34 ± 0,76 g, imunossuprimidos com metil predinisolona (200 mg/kg), anestesiados com associação de xilazina (1,5 mg/kg) e cetamina (200 mg/kg) intraperitoneal. Foram realizados três grupos associados aos implantes, Grupo controle (G1), no qual foi implantado somente cateter estéril; no grupo 2 (G2), implantou-se cateter mais 0,01 ml de suspensão com Candida tropicalis; já o grupo 3 (G3) recebeu cateter impregnado com biofilme contaminado por Candida tropicalis. Após a deposição do fragmento no interior vesical o cateter 20G foi retirado seguido da cistorrafia. Os animais foram eutanasiados com três e seis dias após o procedimento. Não houve diferença entre os grupos cirúrgicos, porém houve uma perda significativa de peso de 1,90 ± 1,33 g (p=0,0001), porém, similar entres os grupos (p=0,8320) e baixo índice de complicações (p=0,8345) no transcirúrgico. Analises histopatológicas realizadas na bexiga, apresentou lesões similares entre os grupos (p=0,8779), nos rins congestão, estenose tubular, necrose tubular, cilindros hialinos, congestão glomerular e glomerulonefrite proliferativa, somente no G3 apresentou diferença (p=0,0452) com relação à glomerulonefrite proliferativa. Em conclusão, a presente técnica de implante intravesical de fragmento de cateter para estudos de agentes causadores de infecções do trato geniturinário em Mus musculus foi eficiente devido à sua exequibilidade e aos baixos índices de complicações.

The objective of this work is to create an experimental model that allows the introduction of an implant with or without pathogen containing non-lumen of the urinary vesicle in mice. Fourteen eight-week-old isogenic Balb / c mice, mean weight of 15.34 ± 0.76 g, immunosuppressed with methyl predinisolone (200 mg / kg), anesthetized with xylation association (1.5 mg / kg) and ketamine (200 mg / kg) intraperitoneally. Three groups were associated with implants, Control group (G1), not qualified for implantation, only sterile catheter; no group 2 (G2), catheter was implanted plus 0.01 ml of suspension with Candida tropicalis; Group 3 (G3) is an indwelling catheter with biofilm contaminated with Candida tropicalis. After deposition of the non-bladder fragment, the 20G catheter was removed followed by cystorraphy. The animals were euthanized three and six days after the procedure. There was no difference between the surgical groups, but there was a significant weight loss of 1.90 ± 1.33 g (p = 0.0001), but similar to groups (p = 0.8320) and low complication rate ( p = 0.8345) non-trans-surgically. Histopathological analyzes performed in the bladder showed similar lesions between the groups (p = 0.8779), in the congestive kidneys, tubular stenosis, tubular necrosis, hyaline cylinders, glomerular congestion and proliferative glomerulonephritis, only in G3 presented difference (p = 0.0452 ) with respect to proliferative glomerulonephritis. In conclusion, a present technique of intravesical catheter fragment implantation for studies of agents causing genitourinary tract infections in Mus musculus was efficient due to its feasibility and the low rates of complications.