Use of Octopus™ Tissue Stabilizer for Minimal Manipulation Approach of Bronchial Anastomosis in Lung Transplant.

Bronchial anastomotic complications are a cause of grave concern for surgeons that perform lung transplantations. There are several risk factors that may lead to this complication, being inadequate surgical technique one of them, specifically regarding adequate exposure and manipulation of the bronchial stump and anastomosis. Here we report the use of Octopus™ Tissue Stabilizer as a mean to allow for a better exposure of the stump and facilitate a "no-touch" approach towards anastomosis. Systematic application of devices that facilitate the employment of the correct surgical techniques can have an effect in reducing the incidence of bronchial anastomotic complications.

INTRAMUSCULAR MARTIN-GRUBER ANASTOMOSIS.

OBJECTIVE: : This paper reports the incidence, origin, course and anatomical relationships of intramuscular Martin-Gruber anastomosis. METHODS: : Anatomical dissection of 100 limbs from 50 adults cadavers was performed. The intramuscular Martin-Gruber anastomosis was found in five forearms, three in the right and two in the left side, one was bilateral. All communication were located between the anterior interosseous nerve and the ulnar nerve. CONCLUSION: : The purpose of intramuscular Martin-Gruber anastomosis, which we found in 5% of dissected limbs, is to supply the flexor digitorum profundus muscle and it is unlikely to have any influence on the innervation of the intrinsic muscles of the hand. Level of Evidence IV, Cases Series.

ANATOMIC STUDY OF THE NERVOUS COMMUNICATION BETWEEN THE MEDIAN AND MUSCULOUCUTANEOUS NERVE.

OBJECTIVE: The aim of this study was to analyze the incidence of nerve communication between the musculocutaneous and median nerve . METHODS: Anatomical dissection of 40 limbs from 20 fetal cadavers was performed at the Laboratory of Anatomy, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo . RESULTS: A communicating branch was found in 10 upper limbs. In nine limbs there was a musculocutaneous-median anastomosis (type I); and in one limb there was a median-musculocutaneous anastomosis (type II) . CONCLUSION: It is very important to know these anatomical variations, especially when considering clinical examination, diagnostic, prognostic and surgical treatment. Level of Evidence IV, Case Series.