Zero-Heat Internal Thoracic Artery Harvesting Using Water Jet: An Experimental Study

Area of Science:

• Cardiovascular Surgery
• Surgical Technology
• Minimally Invasive Procedures

Background:

• The internal thoracic artery (ITA) is a critical vessel for coronary artery bypass grafting.
• Traditional ITA harvesting methods, such as electrocautery, can lead to thermal injury and damage to surrounding tissues.
• Exploring novel technologies for safer and more effective ITA harvesting is essential for improving surgical outcomes.

Purpose of the Study:

• To assess the feasibility and safety of harvesting the internal thoracic artery (ITA) using water jet (WJ) technology.
• To compare the tissue-sparing effects of WJ harvesting versus traditional electrocautery.

Main Methods:

• The ERBEJET 2 hydrosurgical system was employed for skeletonized ITA harvesting in a swine model.
• Device settings were optimized at 30 bar for selective tissue dissection, prioritizing vessel preservation.
• Histological analysis of harvested tissue samples was performed to evaluate coagulation and hemorrhage, comparing WJ with electrocautery.

Main Results:

• Water jet (WJ) harvesting showed significantly less frequent and less severe coagulation compared to electrocautery (26.3% vs 96.0%, P < .01).
• Hemorrhage was less severe in the WJ group (1.11 ± 0.32 vs 1.88 ± 0.97, P < .01).
• No thermal injuries were observed with WJ harvesting, unlike electrocautery.

Conclusions:

• Water jet (WJ) harvesting of the internal thoracic artery (ITA) demonstrates reduced tissue damage compared to electrocautery.
• WJ technology presents a promising alternative for ITA harvesting, potentially enhancing surgical safety and efficacy.
• Further clinical studies are warranted to confirm these findings in human patients.