Video assisted endoscopic saphenous vein harvest

Summary

The saphenous vein remains the mainstay as the conduit in a great majority of coronary artery bypass operations. The traditional method of vein harvesting results in substantial morbidity. An alternate, less traumatic method for saphenous vein harvest is desirable to reduce or eliminate healing problems in the legs. A system of endoscopic vein harvest was utilized to harvest the saphenous vein through one or more small incisions in 81 patients from 14 May 1996 to 12 September 1996. The system consists of subcutaneous tunnelling and dissecting instruments using a video camera for visualization. To date, no major wound complications have been encountered in 114 harvest sites. Minor drainage, haematomas or ecchymoses have not required additional treatment and have not delayed recovery. Patient acceptance has been enthusiastic. We conclude that this technology represents a breakthrough in reducing the annoying and costly morbidity associated with saphenous vein harvest. The initial cost of the equipment and longer operating times initially will be more than offset by a reduction in the need for follow-up treatment and avoidance of delayed recovery.