To make a breast with skin and fat from the tummy or inner thigh after a mastectomy, involves some 'plumbing'. The tummy or inner thigh tissue with its blood supply is completely disconnected and detached from the body. It is then placed on the chest and the blood vessels or 'pipes' are connected to those under the ribs. The size of the these 'pipes' is very small- between 1 to 3 mm in diameter.
So similar to a plumbing pipe-coupler, plastic surgeons use a coupling device as shown in the picture, to join up the vein using an operating microscope. This has reduced the time taken to connect the veins from 45-50 mins when sutured by hand, down to approximately 8 mins when the coupler is used. In an operation that takes 6 hours , this is a significant time saving and results in less time under an anaesthetic for the patient. And it ensures that a sidewall of the vein is not caught up in a stitch, something one has to look out for in a hand-sewn 'plumbing' of the vein.
For the last 8 years, every Tuesday, when I reconstruct a breast using skin and fat from the tummy (DIEP) or from the inner thigh (TUG), I count the venous coupler as one of my blessings- it makes my surgical life a little bit safer, quicker and more controlled, both for me and for my patients.
So similar to a plumbing pipe-coupler, plastic surgeons use a coupling device as shown in the picture, to join up the vein using an operating microscope. This has reduced the time taken to connect the veins from 45-50 mins when sutured by hand, down to approximately 8 mins when the coupler is used. In an operation that takes 6 hours , this is a significant time saving and results in less time under an anaesthetic for the patient. And it ensures that a sidewall of the vein is not caught up in a stitch, something one has to look out for in a hand-sewn 'plumbing' of the vein.
For the last 8 years, every Tuesday, when I reconstruct a breast using skin and fat from the tummy (DIEP) or from the inner thigh (TUG), I count the venous coupler as one of my blessings- it makes my surgical life a little bit safer, quicker and more controlled, both for me and for my patients.
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