Abstract: Paired vascular clamps simplify laparoscopic vascular reconstruction surgery by providing an instrument for bringing vessel ends together to a reasonable working distance under a controlled fashion. A first clamp, with a pivoted connecting arm, and a second clamp with a lock/release device for attaching the second clamp to the connecting arm, can be inserted through an trocar or other port into a surgical field and then positioned on with the first clam and the second clamp in side-by-side and substantially parallel relationship, so that said first clamp and said second clamp can hold and position one or more vessels or elongated tissues. A laparoscopic approximator-everter has extendable blades for gripping blood vessel edges or other tissue to be anamosted, and an extendable sheath that can be advanced to surround the blades.