Endoscopic vessel harvesting: good or bad?

The use of less invasive approaches for saphenous vein or radial artery procurement in CABG surgery has gained popularity during the past decade. The purpose of the present review is to focus on the safety and the potential advantages of minimally invasive conduit harvesting in coronary surgery.

There is ample evidence in literature that the use of a less invasive approach for conduit (either saphenous vein or radial artery) procurement could yield consistent advantages over the conventional approach, in particular with respect to a lower incidence of wound complications, pain reduction and improved cosmetic results. Nevertheless, some recent studies raised concerns in terms of potential damage occurring to the harvested conduits with the endoscopic approach, which could therefore jeopardize the longevity of the graft itself.

Endoscopic conduit harvesting is a well-tolerated and effective procedure. The majority of scientific reports depicted that the minimally invasive approach does not compromise the quality of the harvested conduits and therefore does not lead to a higher incidence of graft failure or cardiac-related events in the mid-long term. The endoscopic technique should be the approach of choice for saphenous vein and radial artery procurement in CABG surgery; recent technical and technological advancements could further improve outcomes.