Minimally invasive saphenous vein harvesting

• Published in: The Annals of thoracic surgery Vol. 66; no. 3; pp. 1026 - 1028
• Main Authors: Morris, Rohinton J, Butler, Michael T, Samuels, Louis E
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1998; Elsevier Science
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass - methods; Coronary Disease - surgery; Coronary heart disease; Endoscopy; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Pain, Postoperative; Pneumoperitoneum, Artificial; Saphenous Vein - surgery; Saphenous Vein - transplantation; Treatment Outcome; Human; Endoscopic surgery; Treatment; Aortocoronary; Bypass; Saphenous vein; Surgery; Samplings; Cardiovascular disease; Technique; Coronary heart disease; Result
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(98)00709-7

Background. Minimally invasive techniques to harvest the saphenous vein for coronary artery bypass grafting continue to improve and evolve. Smaller cutaneous incisions have been shown to decrease postoperative discomfort and improve healing. We describe a technique involving carbon dioxide insufflation and endoscopic dissection to allow easier and atraumatic dissection. Methods. The VasoView endoscope system (Origin Medsystems, Inc) was used to harvest the saphenous vein for coronary artery bypass grafting in 27 patients. This group was compared with 24 patients having traditional saphenous vein harvesting. Wounds were examined for complications daily. Pain and postoperative mobility were quantified independently by physical therapists. Results. Comparison of patients in the two groups revealed greater edema in the legs with traditional harvesting. Patients with endoscopic removal also had less pain and increased mobility postoperatively. On average, minimally invasive harvesting allowed patients to ambulate to a predischarge goal of 300 ft 2 days earlier. Conclusions. Minimally invasive harvesting of the saphenous vein by insufflation techniques is safe, effective, and atraumatic to the conduit. Discomfort is minimized, promoting earlier and improved ambulation.