Oregon Cryonics
A Non-profit Organization

Manual - Surgical Procedures

Back to Manual.

 

See Aseptic Technique

See Surgical Instruments

 

Cannulation of Carotid Artery

This entire procedure, from initial incision to the beginning of washout on the first artery, can be done reliably and safely in under one minute. If the procedure must be delayed, apply ice packs, cephalic ice bath, or nasopharyngeal irrigation to the head, depending on the situation.  Do not perform CPR.

 

Place body in supine position on a flat table. Slide the backboard of the cephalic ice bath under the head and shoulders.  Slide the body in a superior direction until the neck is in hyperextension and the head is within the ice bath.  Make the initial incision across the superior edge of the sternum and right clavicle with a #22 blade.  Apply pressure to the chin to cause further hyperextension of the neck as the incision deepens.  Keeping the incision near the clavicle, make repeated cuts until the right common carotid artery is exposed.

 

To cannulate the artery, grasp both walls of the artery with cotton forceps.  Use fingers to pull the fascia down the artery, away from the forceps, until 3 cm is clear.  A 4.5 mm cannula will already be connected to the tubing, debubbled, and pumping with low flow.  A nylon tie will be in place loosely on the tubing.   Grasp the lateral wall of the artery with the cotton forceps in the left hand.  While holding both the cannula and the artery at a 45 degree angle to prevent air entrapment, insert the cannula.  Slide the nylon tie down onto the artery, and tighten to secure.  Slide the cannula to verify placement and security.  Washout is now under way with low flow.  Cannulate the contralateral common carotid artery in the same manner.  If there is any leakage at either cannula, apply a second nylon tie or a loop of umbilical tape. 

 

Add ice around the entire head.  Add just enough water to fill some of the voids in the ice.  As ice melts, remove water and add more ice.  Once washout is under way on both arteries, use a surgical hand saw to cut through the vertebral column.  Complete the cephalic isolation with the scalpel.  Look for effluent coming from the vertebral arteries.  If there is effluent, then clamp the vertebral arteries.  If there is no effluent, it may be due to an embolism.  Alternatively, this could be one of the 6% of patients who have an incomplete circle of Willis.  If an incomplete circle is suspected, then attempt to cannulate and perfuse the vertebral arteries with needle cannulae.

 

Pet Thoracotomy

Using rib shears, cut through the full thickness of skin and ribs vertically on both sides of the sternum.  Remove the sternum and attached tissue.  The shape of the cut and the instruments used will depend on the size and species of the animal.  The clavicles are typically cut as well.  Apply a sternal retractor. Dissect out the brachiocephalic trunk, which has a different standard anatomy from that of humans.  The first two branches of the brachiocephalic trunk are the left and right common carotid arteries, and then it continues as the right subclavian artery.  Cannulate the brachiocephalic trunk near the heart.

 

Removal of Brain

(description of procedure to follow later)

 

Brain Case Isolation

(description of procedure to follow later)

 

Pet Removal of Brain

(description of procedure to follow later)