Endoscopic Vein Harvesting

Excerpt

Over the last decade, endoscopic vein harvesting (EVH) has been the method of choice to harvest the greater saphenous vein (GSV), which is the most widely used conduit in coronary artery bypass graft (CABG) surgery. The saphenous veins are often used for their ease of harvesting and length. The global demand for CABG surgery and the increasing need for patients to require multiple coronary artery bypasses in the same procedure have increased the demand for more and better conduits.

In the past, the conventional open technique of GSV harvesting involved a long skin incision, which often carries a higher incidence of wound complications and pain. This is often coupled with increased length of hospital stay and decreased patient satisfaction. The EVH technique has evolved and developed to improve the above-mentioned drawbacks of the open procedure.

Results from a recent review of approximately 28,000 patients from 22 studies found that the mid- and long-term patency of vein conduits harvested using the endoscopic technique was lower than that of the open technique. However, this study was limited to 1 year. The researchers concluded that growing surgical experience in the EVH might be associated with better outcomes. Although the long-term patency of harvested conduits by EVH has been questioned, many studies show that the patency of vein grafts harvested by the EVH technique is similar to that reported using the conventional method.