Recent progress in minimally invasive conduit harvesting.
Wound-related morbidity frequently encountered after open-incision harvesting of vessel conduits for coronary artery bypass grafting (CABG) is invariably recognized as an obstacle impeding the patient's path towards complete postoperative recovery. The endoscopic approach provides surgical access to the intended conduit vessel while affording an appreciably lower incidence of traumatic injury to the surrounding tissues. For this reason, the minimally invasive endoscopic dissection of vessel conduits is steadily gaining acceptance as a preferable alternative to the standard open-incision technique. Endoscopic systems, originally developed for general surgical procedures in the early 1990s, and readily adapted to saphenous vein harvesting by mid-decade, are now also being applied to minimally invasive radial artery harvesting. The growth of this surgical modality has paralleled the rapid development of remote access minimally invasive endoscopic devices and technologies and therefore remains an evolving body of knowledge. As experience and refinements in instrumentation progress, the endoscopic approach will undoubtedly become the procedure of choice for harvesting vessel conduits. This article provides a practical primer, based on the benefit of our serial experience with endoscopic vein and radial artery dissections, for those considering the minimally invasive endoscopic approach in harvesting vessels for CABG.
Genovesi
Mark H
MH
State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
Robertazzi
Robert R
RR
Vitali
Richard M
RM
Connolly
Mark
M
Subramanian
Valavanur A
VA
D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000191:economics / Q000517:prevention & control; D017534:Radial Artery / Q000637:transplantation*; D012501:Saphenous Vein / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods*