Endoscopic saphenous vein harvest in infrainguinal bypass surgery

Background: Autologous greater saphenous vein is considered to be the optimal material for peripheral arterial reconstruction and coronary artery revascularization. We describe a new endoscopic technique of saphenous vein harvest in infrainguinal arterial bypass surgery. Methods: A retrospective analysis of 64 infrainguinal bypass procedures was performed comparing the standard open technique of saphenous vein harvesting with a new less invasive endoscopic technique. Results: There were no differences in age, gender, indications for surgery, or proximal or distal anastomosis between the two groups. There were also no significant differences in early wound complications, early patency, and transfusion requirements. In the endoscopic group, length of operation was longer (189 versus 158 minutes; P <0.005), length of stay was shorter (5.2 versus 8.1 days; P <0.05), and postoperative day of discharge was also less (3.3 versus 5.5 days; P <0.01). Conclusions: Our findings indicate that endoscopic saphenectomy is technically feasible, leads to earlier discharge from the hospital, and leads to increased operative time. Most importantly, the procedure can be performed safely without subjecting the patient to increased risk.