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 often are used due to their ease of harvesting and length. The global demand for CABG surgery, as well as 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 a decrease in patient satisfaction. The endoscopic vein harvesting technique has evolved and developed to improve the above-mentioned drawbacks of the open procedure.

A recent review of approximately 28000 patients from 22 studies found that mid and long term patency of vein conduits harvested by the endoscopic technique was lower than the open technique. However, this study was limited to one year. The researchers concluded that growing surgical experience in the EVH might be associated with better outcomes.

Although long-term patency of conduits harvested by EVH has been questioned, many studies show that the patency of vein grafts harvested by EVH technique is similar to the patency reported using the conventional method.