Minimally invasive endoscopic saphenous vein harvesting for coronary bypass surgery

Peter Mckeown, Patricia Conant, David Rapaport

Research output: Contribution to journalArticle

Abstract

Saphenous vein harvesting for cardiac surgery is one of the most common surgical procedures performed in the United States. Reported morbidity (5%) includes prolonged wound healing, infected surgical sites, with pain and discomfort from the extensive skin incision. Alternative techniques for vein harvesting such as skin bridging have been limited by visualization, ability to minimize vein trauma, and to control bleeding. We have modified the method of saphenous vein harvesting by using lighted retractors and more recently endoscopic instruments and techniques in 7 patients. There has been no apparent increased trauma to the vein and early patient acceptance has been favorable. With the lighted retractor technique 4-6 incisions were made approximately 5 cm in length. This method was utilized in 2 patients. Employing current endoscopic technology coupled with innovative dissectors and retractors, vein harvesting incisions have been reduced to a 5 cm incision at the knee and a 2 cm incision at the groin to ligate the proximal end. In two cases an additional 2 cm incision below the knee was required. Total length of vein harvested varied from 32-55 cm. The endoscopic technique has the potential to diminish the morbidity and discomfort associated with saphenous vein harvesting while allowing excellent visualization and the ability to ligate tributaries successfully. This technique does require more operative time, has a definite learning curve and can be technically challenging in those operators without endoscopic experience. These new techniques provide an alternative safe method for saphenous vein harvesting with the potential for a decrease in wound complications and increased patient satisfaction and require further consideration.

Original languageEnglish (US)
JournalChest
Volume110
Issue number4 SUPPL.
StatePublished - Oct 1 1996
Externally publishedYes

Fingerprint

Saphenous Vein
Veins
Aptitude
Knee
Wounds and Injuries
Morbidity
Skin
Learning Curve
Groin
Operative Time
Patient Satisfaction
Wound Healing
Thoracic Surgery
Hemorrhage
Technology
Pain

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Minimally invasive endoscopic saphenous vein harvesting for coronary bypass surgery. / Mckeown, Peter; Conant, Patricia; Rapaport, David.

In: Chest, Vol. 110, No. 4 SUPPL., 01.10.1996.

Research output: Contribution to journalArticle

Mckeown, Peter ; Conant, Patricia ; Rapaport, David. / Minimally invasive endoscopic saphenous vein harvesting for coronary bypass surgery. In: Chest. 1996 ; Vol. 110, No. 4 SUPPL.
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