Endoscopic Assisted Harvesting of the Radial Artery for Coronary Artery Bypass Grafting: A Modified Technique

The present study evaluates a minimally invasive technique for radial artery harvesting for coronary artery bypass grafting (CABG). The decision to use the radial artery for grafting was taken by the cardiac surgeons in Cairo university hospitals. 30 patients were enrolled in this study in the period from February 2002 to August 2005. Allen s test, modified Allen s test, and duplex scanning were the preoperative measures to assess ulnar collateral circulation. A 2 incisions policy was adopted with a 14 cm tunnel inbetween. 2 nasal speculae were used as retractors, with a 30° 5 mm endoscope for visualization, and a harmonic scalpel as haemostatic, dissection, and cutting instrument. In all the patients, harvested grafts ranged between 18 and 22 cm and all were usable. No hand ischemia or graft thrombosis were encountered. Complications involved one (3.3%) tunnel hematoma that was surgically evacuated, 2 cases (6.7%) with bruises in the forearm, 2 (6.7%) with minor wound infection, 2 (6.7%) with numbness of the thenar eminence, and one (3.3%) with neurogenic functional disorder of the thumb. 28 out of the 30 studied patients markedly appreciated the cosmetic outcome. The remaining 2, one had a long scare after exploration of tunnel hematoma, and the other was disappointed with the functional thumb affection.