VIDEO-ASSISTED ENDOSCOPIC SAPHENOUS-VEIN HARVEST

The saphenous vein remains the mainstay as the conduit in a great majo rity of coronary artery bypass operations. The traditional method of v ein harvesting results in substantial morbidity. An alternate, less tr aumatic method for saphenous vein harvest is desirable to reduce or el iminate healing problems in the legs. A system of endoscopic vein harv est was utilized to harvest the saphenous vein through one or more sma ll 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 compl ications have been encountered in 114 harvest sites. Minor drainage, h aematomas or ecchymoses have not required additional treatment and hav e not delayed recovery. Patient acceptance has been enthusiastic. We c onclude 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 initiall y will be more than offset by a reduction in the need for follow-up tr eatment and avoidance of delayed recovery.