MINIMALLY INVASIVE VEIN HARVESTING - A COMPARISON OF ENDOSCOPIC VERSUS TRADITIONAL OPEN SAPHENECTOMY

The greater saphenous vein (SV) is the conduit of choice for coronary and infrapopliteal revascularization procedures. Unfortunately, to har vest an SV it is often necessary to make an incision the length of the leg, and this is associated with a significant incidence of wound com plications. Minimally invasive procedures have several advantages incl uding reduced incidence of wound complications, decreased hospital len gth of stay, and, therefore, health-care savings. Currently, little in formation is available that compares traditional open saphenectomy (OS ) versus a minimally invasive procedure, endoscopic saphenectomy (ES). The purpose of this study was to compare SV harvest time, incision le ngth, and harvested vein quality between the OS and ES techniques in s ix nonpreserved cadavers. Each limb was randomly selected for either O S or ES. The length of incision, number of SV leaks after harvest, len gth of SV, and time required for harvest were recorded for each techni que. The table summarizes the findings of the cadaver dissections. [GR APHICS] Per limb, no difference was noted in vein harvest length or nu mber of leaks between OS and ES. A significant reduction was found in incision length for ES (14.4+/-1.4 cm per limb), but the time required for OS was significantly shorter (P=0.01). This study suggests an equ ivalent length of SV can be harvested with either OS or ES techniques; however, with the ES technique there is a reduction in incision lengt h and, therefore, a less morbid operative technique.