Learning process and results in endoscopic saphenous vein harvesting technique

Background: The most common conduit for coronary artery bypass graft (CABG) surgery is saphenous vein graft (SVG). There are two techniques for SVG harvesting: open and endoscopic. Our aim is to evaluate clinical results of endoscopic versus open SVG harvesting. Nowadays, endoscopic vein harvesting (EVH) has become prevalent because of reduced complications with more patient satisfaction. Objective: We designed and performed a prospective randomized cohort study of patients undergoing CABG to compare the results of open versus endoscopic harvesting technique. Methods: Patients who underwent elective CABG at our hospitals were divided into two groups, during the period of January 2019 to March 2021. The EVH group (50 patients) underwent endoscopic technique compared with the open vein harvesting (OVH) group (50 patients) that was underwent open surgical incision for great saphenous vein (GSV) harvesting. The two groups demographically were similar and received identical management. Leg wound was evaluated at discharge, two weeks, and four weeks for evidence of any complications. Early outcomes were recorded, including infection, gaped wound and surgical re-suture, degree of pain, level of cosmetic satisfaction, and early mobilization. Results: In the EVH group, harvesting time increased, and incision closure time decreased in comparison with OVH. The hospital stay was 5.5 ± 2.4 days in the EVH group versus 9.5 ± 2.7 days in the OVH group. Leg wound complications were significantly reduced in the EVH group in comparison with the OVH group. Conclusions: Endoscopic vein harvesting technique reduced leg wound complications. Conveniently, patients also were cosmetically satisfied.

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A Novel Technique of Endoscopic Vein Harvesting With Preserved Perivascular Tissue

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/1556984520948139 ◽

2020 ◽

Vol 15 (5) ◽

pp. 475-477

Author(s):

Kunihiko Yoshino ◽

Kohei Abe ◽

Koyu Suzuki ◽

Rihito Tamaki ◽

Atusyuki Mituishi ◽

...

Keyword(s):

Saphenous Vein ◽

Histopathological Examination ◽

Wound Complications ◽

Connective Tissues ◽

Endoscopic Vein Harvesting ◽

Harvesting Technique ◽

A New Technique ◽

Vein Harvesting ◽

The Ideal

The no-touch saphenous vein harvesting technique is considered to be the ideal procedure to achieve the best quality of vein, whereas the endoscopic vein harvesting (EVH) technique is considered to be ideal for decreasing wound complications. We developed a new technique of EVH with perivascular tissue preservation. This procedure was performed by dissecting the immediate anterior and posterior perivascular connective tissues of the saphenous vein followed by cutting approximately 1 cm laterally from the saphenous vein with the use of a harvester (MAQUET Getinge Group, Getinge AB, Göteborg, Sweden). Histopathological examination revealed preserved perivascular tissue and intimal folding.

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Endoscopic Saphenous Vein Harvesting for Hemodialysis Vascular Access Creation in the Forearm: A New Approach for Arteriovenous Bridge Graft

The Journal of Vascular Access ◽

10.1177/112972980300400304 ◽

2003 ◽

Vol 4 (3) ◽

pp. 98-101 ◽

Cited By ~ 2

Author(s):

T. Oto

Keyword(s):

Vascular Access ◽

Saphenous Vein ◽

Prosthetic Graft ◽

Wound Complications ◽

Ptfe Graft ◽

New Approach ◽

Av Fistula ◽

Harvesting Technique ◽

Hemodialysis Vascular Access ◽

Vein Harvesting

When superficial arm veins are not suitable to create a native arteriovenous (AV) fistula, an arteriovenous bridge graft by native and/or prosthetic graft is the next best alternative. However, harvesting a native vein, such as the saphenous vein (SV), is invasive and requires a large incision. We report an endoscopic saphenous vein harvesting (ESVH) technique combined with forearm bridge grafting as a new approach for vascular access (VA). Methods We used the Clearglide, Endoscopic Vessel Harvesting System (Eticon, Inc.) for a less invasive SV harvesting technique. Five patients had a SV graft implant and 10 patients had a polytetrafluoroethylene (PTFE) graft implant in the forearm. Results The SV was harvested easily in all patients in 46 ± 2 min. There were no wound complications. All SV and PTFE grafts provided satisfactory access within 1 month; however, two declotting procedures in the SV group and five in the PTFE group were required. The PTFE group had two graft infections. Conclusions It is possible that a combination of ESVH and SV forearm grafting will be one of the new approaches for hemodialysis (HD) access.

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Effect of Endoscopic Versus Open Saphenous Vein Harvesting Technique on Leg Wound Complications

10.22541/au.160907624.44598429/v1 ◽

2020 ◽

Author(s):

Yasser Mubarak

Keyword(s):

Saphenous Vein ◽

Artery Bypass ◽

Wound Complications ◽

Endoscopic Vein Harvesting ◽

Patient’S Satisfaction ◽

Harvesting Technique ◽

Incision Location ◽

Open Versus ◽

A Prospective Study ◽

Vein Harvesting

Background: EVH has become prevalent in recent years due to its reduced morbidity and increased patient satisfaction. We designed and carried out a prospective study of patients undergoing CABG to compare outcomes of open versus endoscopic harvesting technique for great saphenous vein. Two groups of patients who underwent elective Coronary artery bypass grafting at our hospitals between January 2018 and October 2020 were included. Endoscopic vein harvesting group (50 patients) was performed endoscopic technique compared with Open Vein Harvesting group (50 patients) was performed open surgical incision for harvesting. Both groups were demographically similar and received identical management. Leg wound was evaluated at discharge, 2 weeks, and 4 weeks for evidence of complications. Early outcomes were compared included, infection, gaped wound and re-suture, pain, satisfied cosmetically and mobilization. Results: Endoscopic vein harvesting group had increased harvest time and decreased incision closure time when compared with Open Vein Harvesting. The average hospitalization time was 6.5 ± 2.2 days for Endoscopic vein harvesting group and 9.2 ± 2.9 days for Open Vein Harvesting group. In Endoscopic vein harvesting group, no significant hematomas were observed. In Open Vein Harvesting group, hematomas were detected in 2 patients and were surgically evacuated. In Endoscopic vein harvesting group, edema occurred less frequently. Infection of the incision location did not occur in Endoscopic vein harvesting group. Leg wound complications were significantly reduced in Endoscopic vein harvesting group in comparison with Open Vein Harvesting group. Conclusions: Endoscopic vein harvesting decreases leg wound complications and increases patient’s satisfaction cosmetically.

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The endoscopic no-touch saphenous vein harvesting technique

10.1510/mmcts.2020.049 ◽

2020 ◽

Keyword(s):

Saphenous Vein ◽

Wound Complications ◽

Video Tutorial ◽

Vessel Sealing ◽

Co2 Insufflation ◽

Harvesting Technique ◽

Sealing Device ◽

Bipolar Vessel Sealing ◽

Bipolar Vessel ◽

Vein Harvesting

The no-touch saphenous vein harvesting technique is being increasingly used; however, this technique causes more leg wound complications than conventional techniques. Endoscopic saphenous vein harvesting is considered a safe and effective approach for reducing leg complications, despite the fact that experience with this technique remains limited, because leg CO2 insufflation and dissection with a tip cannula to isolate the vein enables the graft to naturally skeletonize. In this video tutorial, we demonstrate our endoscopic no-touch saphenous vein harvesting technique using a reusable saphenous vein retractor system without CO2 insufflation and an electrothermal bipolar vessel sealing device.

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