Liver transplantation: Microsurgical expertise - how will it benefit in doing a perfect surgical procedure?

Perfecting small vessel suturing is an art in itself. Hepatic arteries (blood vessel that supplies oxygenated blood to the liver) are usually 4 - 5 mm in diameter and connected to the new liver with the blood supply of the patient at the time of liver transplantation. Hepatic arteries of much smaller diameter can be encountered in liver transplantation for children and in split liver transplants. Maintaining potency of the artery in these transplants is a challenge. The Japanese surgeons started using the surgical microscope for the reconstruction of these vessels and learned the technique of reconstructing these blood vessels from plastic surgeons. This technical expertise has been useful in reducing the number of hepatic arteries that thrombose in the post operative period.

The above video is a microsurgical reconstruction of 1 mm vessels in the laboratory done by the author to improve skills to handle small vessels encountered in liver transplantation.