Endoscopic vs conventional vein harvesting: a prospective analysis

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Surgical Techniques

Background:

• Minimally invasive vein harvesting offers potential benefits for wound healing and infection rates.
• Coronary artery bypass grafting (CABG) frequently utilizes vein grafts for revascularization.

Purpose of the Study:

• To compare the outcomes of endoscopic vein harvesting (EVH) versus conventional open vein harvesting (OVH) in patients undergoing elective CABG.
• To evaluate operative time, learning curve, graft quality, and wound complication rates between the two harvesting methods.

Main Methods:

• A prospective, non-randomized study comparing 81 patients undergoing EVH (Group 1) with 80 patients undergoing OVH (Group 2).
• Data collected included operative time, number of suture repairs per vein, and wound infection incidence.

Main Results:

• Endoscopic vein harvesting was significantly faster (51.07 min) than open harvesting (75.94 min).
• The learning curve plateau for EVH was reached at 20 cases for 2 vein lengths and 35 cases for 3 vein lengths.
• Group 1 required more suture repairs per vein (1.32) compared to Group 2 (0.38).
• Wound infection incidence was substantially lower in the EVH group (1.2%) versus the OVH group (8.8%).

Conclusions:

• Endoscopic vein harvesting is a feasible and effective technique for CABG.
• EVH demonstrates significant advantages in reduced operative time and lower wound infection rates compared to OVH.
• The technique is not difficult to learn and should be considered the preferred method due to improved wound healing outcomes.