vesselpreserving

Vesselpreserving is a term used to describe surgical and interventional strategies aimed at maintaining the integrity and function of blood vessels during procedures. The goal is to preserve native perfusion, minimize vascular injury, reduce ischemic damage to organs, and improve postoperative function. This approach contrasts with methods that sacrifice vessels to gain access or obtain distant margins.

Vesselpreserving concepts are applied across multiple specialties. In liver surgery, techniques focus on parenchyma-sparing resections and careful dissection near major hepatic vessels. In kidney surgery, partial nephrectomy seeks to remove tumors while preserving the renal arteries, veins, and nephrons. In pancreatic surgery, vessel-preserving pancreatectomy aims to conserve arterial and venous supply to the remaining pancreas. Gynecologic procedures may preserve ovarian or uterine vessels when possible, and in neurosurgery, efforts are made to spare cerebral arteries and perforators. Trauma and vascular surgery also employ vessel-preserving methods such as reconstruction and bypass when feasible.

Key methods include thorough preoperative planning with vascular imaging (computed tomography angiography, magnetic resonance angiography), intraoperative imaging and monitoring (Doppler ultrasound, indocyanine green fluorescence), meticulous microsurgical dissection, selective clamping or zero-ischemia techniques, and, when required, vessel reconstruction or grafting.

Indications typically center on maintaining organ perfusion, reducing ischemia-reperfusion injury, and preserving function, particularly when preserving vessels can achieve better long-term outcomes. Limitations include increased technical complexity, longer operative times, and potential trade-offs with oncologic or reconstructive goals. Success depends on anatomy, surgeon experience, and multidisciplinary collaboration.