eComment: Minimally invasive endoscope-enhanced venous conduit harvesting techniques

Objective: Endoscopic vein harvest for lower extremity arterial bypass technique has been questioned due to concern for endothelial damage during procurement. We sought to compare NO mediated endothelial dependent relaxation (EDR) in vein segments harvested with open surgical (OH) versus endoscopic (EH) techniques. Methods: Saphenous vein segments were harvested for lower extremity bypass. 3-4mm vein rings were mounted on force transducers. Segments were mounted in 37° oxygenated Krebs solution and maximally contracted using KCl. NE was used to achieve submaximal contraction. EDR was determined using increasing concentrations of bradykinin (BDK). Endothelial independent relaxation was confirmed using sodium nitroprusside. Two-way ANOVA was used to analyze differences between harvest techniques across BDK concentration. Student t-test was used to examine nitrite levels in each cohort. Results: Vein segments harvested from patients (n=13) led to 28 rings (11 rings; 5 patients EH v. 17;8 OH). Both cohorts achieved moderate relaxation to maximal BDK concentration, [10 -6 M]; (49.5% EH vs. 40.55%, OH, P = .270). Analysis by two way ANOVA for mean % relaxation for BDK concentration [10 -11 - 10 -6 M] showed improved EDR in EH samples compared to OH (P =.029). Mean nitrite tissue bath concentration measurements post-BDK were 279 nM (EH) v. 194 nM (OH) (P = .264). Histology and IHC confirmed intact endothelium by morphometric analysis and CD31 staining. Conclusion: Endothelial function is preserved when utilizing endoscopic harvesting techniques. The advantages of minimally invasive vein procurement for lower extremity bypass can be obtained without concern for damaging venous endothelium.

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Comparison of Minimally Invasive versus Conventional Open Harvesting Techniques for Iliac Bone Graft in Secondary Alveolar Cleft Patients

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e31821b6336 ◽

2011 ◽

Vol 128 (2) ◽

pp. 485-491 ◽

Cited By ~ 25

Author(s):

Sheel Sharma ◽

Lisa F. Schneider ◽

Jason Barr ◽

Shahram Aarabi ◽

Patricia Chibbaro ◽

...

Keyword(s):

Minimally Invasive ◽

Bone Graft ◽

Iliac Bone ◽

Alveolar Cleft ◽

Iliac Bone Graft ◽

Harvesting Techniques

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Endothelial function of human vena saphena magna prepared with different minimally invasive harvesting techniques

European Journal of Cardio-Thoracic Surgery ◽

10.1016/s1010-7940(00)00549-2 ◽

2000 ◽

Vol 18 (4) ◽

pp. 400-403 ◽

Cited By ~ 6

Author(s):

Alexander M. Fabricius ◽

Andreas Oser ◽

Anno Diegeler ◽

Thomas Rauch ◽

Friedrich W. Mohr

Keyword(s):

Minimally Invasive ◽

Endothelial Function ◽

Vena Saphena Magna ◽

Harvesting Techniques

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Evolution in ACL Autograft Harvesting Techniques: Transition to Minimally Invasive Autograft Harvesting

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/jaaos-d-20-00803 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

James M. Dennison ◽

James R. Andrews

Keyword(s):

Minimally Invasive ◽

Harvesting Techniques

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A New and Safe Device for Minimally Invasive Saphenous Vein Harvesting: Results after 100 Cases

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/01.imi.0000284379.93878.aa ◽

2007 ◽

Vol 2 (4) ◽

pp. 205-208

Author(s):

Giuseppe D'Arrigo ◽

Gaetano Mauceri ◽

Marco Mudanò ◽

Antonio Scolaro ◽

Filippo Fraggetta ◽

...

Keyword(s):

Minimally Invasive ◽

Saphenous Vein ◽

Vein Graft ◽

Wound Complications ◽

Coronary Surgery ◽

Harvesting Techniques ◽

Reduced Costs ◽

Vein Harvesting

Purpose The saphenous vein is the most commonly used bypass conduit for coronary surgery. Endoscopic harvesting techniques are associated with significant reduction of wound complications but are time-consuming and expensive. The authors developed a device to perform minimally invasive harvesting of the saphenous vein—rapidly, inexpensively, and safely. Description Patients hospitalized for isolated CABG (n = 134) participated in the study. Each vein had been harvested through the use of our minimally invasive system. Evaluation The veins were harvested in 130 cases; 378 vein samples were collected for pathology study, with complete integrity of the vein as the result of the “no touch” technique with the device. This integrity could be very important for the long-term patency of the vein graft. After surgery, there were no wound dehiscences, infections, or major hematomas. There was 1 case (0.76%) of superficial hematoma and 3 cases (2.30%) of lymphoceles. Conclusions Although commercial disposable systems are now available to allow minimally invasive harvesting of the saphenous vein, the authors think that harvesting the greater saphenous vein with the cylinder steel device is easy to learn can be used safely and at much-reduced costs.

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Minimally invasive saphenous vein harvesting techniques: morphology and postoperative outcome

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(00)01370-9 ◽

2000 ◽

Vol 70 (2) ◽

pp. 473-478 ◽

Cited By ~ 45

Author(s):

Alexander M Fabricius ◽

Anno Diegeler ◽

Nicolas Doll ◽

Horst Weidenbach ◽

Friedrich W Mohr

Keyword(s):

Minimally Invasive ◽

Saphenous Vein ◽

Postoperative Outcome ◽

Harvesting Techniques ◽

Vein Harvesting

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Considerations in Dysphagia Management Following Esophagectomy

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.169 ◽

2016 ◽

Vol 1 (13) ◽

pp. 169-176

Author(s):

Lisa M. Evangelista ◽

James L. Coyle

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Surgical Procedures ◽

Esophageal Resection ◽

Minimally Invasive Surgical ◽

Operative Complications ◽

Swallowing Difficulties ◽

Epidemiological Impact ◽

Invasive Techniques ◽

Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

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