An endoscopic subcutaneous dissector for obtaining vein grafts.
Recent improvements in internal mechanical retractors have resulted in a commercially available endoscopic subcutaneous dissector that has an inverted pistol grip for ease of retraction, an end-mounted endoscope channel, and a distal, translucent spoon-shaped shield that maintains the optical cavity. This provides an effective reach that is valuable for the minimally invasive harvest of any long, narrow structure--the greater saphenous vein in particular--as shown in this preliminary study with 2 patients. Such extracted vein grafts taken grossly from above and below the knee appear normal. Long-term histological changes and rates of conduit patency are still unknown. The limited-access incisions necessary for this endoscopic vein harvest definitely are smaller, and can be oriented transversely to minimize further the disfigurement from any resulting scar when compared with traditional methods.
Hallock
G G
GG
Division of Plastic Surgery, The Lehigh Valley Hospitals, Allentown, PA, USA.
Rice
D C
DC
D019723:Endoscopes; D006801:Humans; D012501:Saphenous Vein / Q000637:transplantation; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D014680:Veins / Q000637:transplantation*