A Novel Technique of Endoscopic Vein Harvesting With Preserved Perivascular Tissue

Abstract

The no-touch saphenous vein harvesting technique is considered to be the ideal procedure to achieve the best quality of vein, whereas the endoscopic vein harvesting (EVH) technique is considered to be ideal for decreasing wound complications. We developed a new technique of EVH with perivascular tissue preservation. This procedure was performed by dissecting the immediate anterior and posterior perivascular connective tissues of the saphenous vein followed by cutting approximately 1 cm laterally from the saphenous vein with the use of a harvester (MAQUET Getinge Group, Getinge AB, Göteborg, Sweden). Histopathological examination revealed preserved perivascular tissue and intimal folding.

Towards Endoscopic No-Touch Saphenous Vein Graft Harvesting in Coronary Bypass Surgery

“…Examples of saphenous vein explants at harvesting: A) No-touch, B) conventional, C) endoscopic, and D) no-touch endoscopic. (From Yoshino et al [ 61 ] , 2020). …”

“…B) Transverse section of endoscopic no-touch saphenous vein graft with perivascular adipose tissue intact. (From Yoshino et al [ 61 ] , 2020). C) No-touch saphenous vein with intact luminal endothelium, adventitia, and perivascular fat.…”

“…Another study from a Japanese group also describes a form of endoscopic NT SV harvesting, where the SV is harvested complete with perivascular tissue intact. It is performed via a 3-cm skin incision made at the medial side of the thigh, just above the knee, using Vasoview Hemopro 2 Endoscopic Vessel Harvesting System (Getinge AB, Göteborg, Sweden) [ 61 ] . An important aspect of this study is that histological examinations of the unused portion of the SVG confirmed the preservation of perivascular tissue.…”

Thirty Years of No-Touch Saphenous Vein Harvesting: A Timely Jubilee Gift

“…1 Further progress has been reported recently in which a minimally invasive method of NT SV harvesting has been used, thereby providing an NT SV graft while minimizing leg wound healing problems. 5 However, although wound healing and vascular damage is reduced, the patency of such grafts has yet to be established.…”

The “No-touch” Harvesting Technique Revives the Position of the Saphenous Vein as an Important Conduit in CABG Surgery: 30-year Anniversary

“…Therefore, development of a minimally invasive endoscopic technique for harvesting the NT veins is essential in order for the NT technique to be more widely accepted. Fortunately, a number of recent publications have addressed this important issue whereby the SV is removed with minimal vascular damage, with PVF intact, and reduced wound complications [ 20 ] .…”