Minimally-Invasive Bypass Procedure
Many patients are surprised to learn that a bypass operation includes two surgical procedures: in addition to the bypass operation, where the surgeon uses a healthy blood vessel to "bypass" the blocked arteries of the heart, a second procedure is necessary, to remove (or "harvest") a healthy blood vessel, usually from the leg, to construct the bypass grafts. Recent advances in medical technology make it possible to perform the second procedure in a different way, through very small incisions. This technology is now available at Rush Foundation Hospital.
Traditionally, the vein is removed from the leg through a long incision that may stretch from ankle to groin. Often, patients who have this method of vein removal experience more postoperative pain from the leg incision than from the chest incision. Rehabilitation may be delayed because the longer leg incision may make it more difficult for the patient to stand or walk after surgery.
Guidant Corporation's VASOVIEW Endoscopic Vessel Harvesting System is used in the vessel harvesting procedures at Rush Foundation Hospital. To date, more than 150,000 patients have undergone endoscopic harvesting of the saphenous leg vein. Patients who undergo endoscopic vessel harvesting tend to recover more quickly than those who undergo traditional vessel harvesting. Additionally, they may be at a lower risk for developing post-operative infections due to the smaller incision. The radial artery is harvested in approximately 10 percent of coronary artery bypass surgeries each year.
Guidant's VASOVIEW Endoscopic Vessel Harvesting System, in combination with the Axius Off-Pump System, allow for the OPCRES (Off-Pump Coronary Revascularization with EndoScopic vessel harvesting) procedure. OPCRES combines beating heart bypass surgery with endoscopic vessel harvesting to offer patients multiple benefits, which may include shorter recovery times and a reduced risk for both postoperative infection and cognitive impairment.
Guidant Corporation pioneers lifesaving technology, giving an opportunity for better life today to millions of cardiac and vascular patients worldwide. The company, driven by a strong entrepreneurial culture of 10,000 employees, develops, manufactures, and markets a broad array of products and services that enable less invasive care for some of life's most threatening medical conditions. For more information visit www.guidant.com.
Facts About Endoscopic Vessel Harvesting
What is endoscopic vessel harvesting?
Endoscopic vessel harvesting begins with a small, 2 cm incision into the patient's leg, close to the knee. The clinician inserts a vessel harvesting system into the incision and uses it to dissect the saphenous vein. The vessel harvesting system then infuses CO2 gas into the tunnel, which provides the necessary space for the clinician to harvest the greater saphenous vein.
Once the vein is separated from the surrounding tissue, the clinician then uses the vessel harvesting system to retract, cauterize, and divide tributaries to the saphenous vein that will be harvested. Once this is completed, the vessel is harvested intact and removed from the patient's leg. The harvested vessel is then used as a graft that the surgeon sews in place to bypass the blocked coronary artery.
What is traditional vessel harvesting?
Traditional vessel harvesting procedures require a long incision or a series of incisions down the length of the patient's leg, from the groin to the ankle. The greater saphenous vein is harvested intact through this large incision. The harvested vessel is then used as a graft that surgeons sew in place to bypass the blocked coronary artery.
What are some of the potential benefits of endoscopic vessel harvesting procedures?
When compared with conventional open vessel harvesting procedures that require a long incision down the patient's leg, endoscopic vessel harvesting procedures were associated with:
- Reduced wound complications
- Reduced wound infections
- Reduced pain
- Improved cosmesis
What clinical data supports the use of the EVH procedure?
Patients treated with endoscopic vessel harvesting experienced significantly less wound complications than those who received treatment with the open vessel harvesting procedure
Conduit quality of an endoscopically harvested vein is similar to a conventionally harvested vein.