Video-assisted endoscopic saphenous vein harvest: an evolving technique

Saphenous vein harvest is a necessary step in many cardiac and peripheral vascular reconstructions. However, saphenectomy is not inconsequential and can lead to short- and long-term morbidity. To avoid the morbidity, new technology has been developed to remove the saphenous vein with limited incisions using video-assisted, or endoscopic, techniques. Although a number of manufacturers have developed equipment for this purpose, we have developed expertise with the Ethicon Endo-Surgery (Cincinnati, OH) system. We have used this technique for more than 100 lower-extremity bypass operations with minimal wound complications and satisfactory revascularization. The technical features of this operation are presented.