Endoscopic Vein Harvest

The coronary artery bypass operation requires conduits such as reversed saphenous vein to create bypass grafts from the aorta to the target coronary arteries. Traditionally such vein conduits have been harvested using an open technique. That technique required a long incision that extended along the inside of the leg. The incision length would approximately equal the length of the harvested vein. Frequently those incisions would extend from the ankle to the groin. That open technique frequently produced significant difficulties with wound healing including marked leg swelling, pain, infection, and consequently delayed ambulation. Frequently patients would complain of the leg incision as their most significant post operative disability. It was a painful process that remained with the patient long after the chest incisions had healed.

Four years ago our practice adopted a technique that avoids the morbidity associated with traditional vein harvesting methods. We have employed an endoscopic technique (Video Vein Harvesting) that allows removal of the saphenous vein through one or two 2-centimeter long incisions (instead of the older full length incision). The endoscope is similar to that used for laproscopic cholecystectomy. Advantages include minimal local discomfort, excellent wound healing, and essentially no inflammation and subsequent leg swelling. Patients are able to walk without significant leg discomfort within 24 hours of surgery. Because the leg incision is not a major point of concern, patients can more actively participate in the cardiac rehabilitation program thereby achieving a more rapid overall recovery. Hospital stays are shortened because of the reduction in the number of leg related complications. Furthermore the very small incisions are far less disfiguring and much more cosmetically appealing to all patients.

Our preoperative teaching nurses describe the endoscopic technique to patients as a part of the routine. Patients frequently comment how pleased they are to not have to endure the discomfort of the older technique.  

We have brought this technique to Northern Michigan Hospital as another innovation designed to provide excellent patient outcomes with a minimum of related complications and discomfort. It is our expectation the use of the Video Vein Harvesting technique will continue to contribute toward both a faster and a more comfortable recovery for the majority of our patients.