Minimally invasive vein harvesting — video-assisted vein harvesting

  • R. Coppoolse
  • W. Rees
  • M. G. Muniputanna
  • D. Oefler
  • H. Warnecke


Minimally invasive vein harvesting by endoscopic techniques has become technically feasible during recent years. A variety of techniques have been developed in order to obviate long skin incisions (1-4, 6, 7, 9, 10, 13-15). These procedures, however, have raised limited enthusiasm and have not gained widespread acceptance. This is in contrast to the large scale scientific effort towards minimizing thoracic incisions. Saphenectomy, however, leads to far longer skin incisions and a much higher prevalence of wound complications and pain than median sternotomy. Although severe morbidity like sepsis or amputation are encountered only in rare instances (11), major complications such as wound dehiscence, excessive drainage, lymphangitis and delayed wound healing are reported in up to 24% of patients resulting in severe patient discomfort and additional cost (8, 11, 16). In spite of this, the operative technique of saphenectomy has not been improved significantly since the advent of coronary revascularization. Interrupted skin incisions were the only technical proposal for reducing these complications but were not generally accepted. However, starting in 1996, minimally invasive vein harvesting has been described as an alternative procedure in a few centers.


Saphenous Vein Side Branch Great Saphenous Vein Left Internal Mammary Artery Delayed Wind Healing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Allen K, Griffith G, Heimansohn D, Robison R, Matheny R, Schier J, Fitzgerald E, Shaar C (1998) Endoscopic versus traditional saphenous vein harvesting: a prospective, randomised trial. Ann Thorac Surg 66:26–32PubMedCrossRefGoogle Scholar
  2. 2.
    Black EA, Guzik TJ, West NE, Campbell K, Pillai R, Ratnatunga C, Channon KM (2001) Minimally invasive saphenous vein harvesting: effects on endothelial and smooth muscle function. Ann Thorac Surg 71(5):1503–1507PubMedCrossRefGoogle Scholar
  3. 3.
    Cable D, Dearani J, Pfeifer E, Daly R, Schaff H (1998) Minimally invasive saphenous vein harvesting: endothelial integrity and early clinic results. Ann Thorac Surg 66:139–143PubMedCrossRefGoogle Scholar
  4. 4.
    Cisowski M, Wites M, Gerber W, Drzewiecka-Gerber A, Bochenek A (2000) Minimally invasive saphenous vein harvesting for coronary artery bypass grafting — comparison of three less invasive methods. Med Sci Monit 6(4):735–739PubMedGoogle Scholar
  5. 5.
    Coppoolse R, Rees W, Krech R, Hufnagel M, Seufert K, Warnecke H (1999) Routine minimal invasive vein harvesting reduces postoperative morbidity in cardiac bypass procedures. Clinical report of 1400 patients. European Journal of Cardio-Thoracic Surgery 16(Suppl 2):S61–S66PubMedCrossRefGoogle Scholar
  6. 6.
    Cusimano R, Dale L, Butany J (1996) Minimally invasive cardiac surgery for removal of the greater saphenous vein. Can J Surg 39(5):386–388PubMedGoogle Scholar
  7. 7.
    Davis Z, Jacobs H, Zhang M, Thomas C, Castellanos Y (1998) Endoscopic vein harvest for coronary artery bypass grafting: technique and outcomes. J Thorac Cardiovasc Surg 116:228–235PubMedCrossRefGoogle Scholar
  8. 8.
    De Laria G, Hunter J, Goldin M, Serry C, Javid H, Najafi H (1981) Leg wound complications with coronary revascularization. J Thorac Cardiovasc Surg 81:403–407Google Scholar
  9. 9.
    Dusterhoft V, Bauer M, Buz S, Schaumann B, Hetzer R (2001) Wound-healing disturbances after vein harvesting for CABG: a randomized trial to compare the minimally invasive direct vision and traditional approaches. Ann Thorac Surg 72(6):2038–2043PubMedCrossRefGoogle Scholar
  10. 10.
    Fabricius AM, Diegeler A, Doll N, Weidenbach H, Mohr FW (2000) Minimally invasive saphenous vein harvesting techniques: morphology and postoperative outcome. Ann Thorac Surg 70(2): 473–478PubMedCrossRefGoogle Scholar
  11. 11.
    Lee KS, Reinstein L (1986) Lower limb amputation of the donor site extremity after coronary artery bypass graft surgery. Arch Phys Med Rehabil 67:564–565PubMedGoogle Scholar
  12. 12.
    Lui WHD, Aitkenhead AR (1991) Comparison of contemporaneous and retrospective assessment of postoperatie pain using the visual analog scale. Br J Anaesth 67:768–771CrossRefGoogle Scholar
  13. 13.
    Lumsden A, Eaves F, Ofenloch J, Jordan W (1996) Subcutaneous video-assisted saphenous vein harvest: report of the first 30 cases. Cardiovasc Surg 4(6):771–776PubMedCrossRefGoogle Scholar
  14. 14.
    Reichenspurner H, Boehm D, Welz A, Reichart B (1998) Minimally invasive cardiac surgery — a fashion or an accepted surgical concept? Z Kardiol 87:594–603PubMedCrossRefGoogle Scholar
  15. 15.
    Tevaearai H, Mueller X, von Segesser L (1997) Minimally invasive harvest of the saphenous vein for coronary artery bypass grafting. Ann Thorac Surg 63(6):119–121CrossRefGoogle Scholar
  16. 16.
    Utley J, Thomason M, Walke D (1989) Preoperative correlates of impaired wound healing after saphenous vein excision. J Thorac Surg 30:147–149Google Scholar
  17. 17.
    Lui WHD, Aitkenhead AR (1991)) Comparison of contampeianuous and retrospective assessment of postoperative pain using the visual analog scale. Br J Anaesth 67:768–771CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • R. Coppoolse
  • W. Rees
  • M. G. Muniputanna
  • D. Oefler
  • H. Warnecke

There are no affiliations available

Personalised recommendations