Endoscopic harvesting of the vena saphena magna for peripheral vascular reconstruction]

By using an endoscopic, video-assisted instrumentarium we harvested the great saphenous vein for peripheral bypass surgery through minimal skin incisions with the purpose to reduce the wound complications.Endoscopic subcutaneous saphenous vein harvesting was performed in 15 patients who underwent peripheral bypass surgery for intermittent claudication. In 6 patients the vein was taken from the affected leg and in 9 patients the vein was harvested from the opposite leg.In every case where the vein was taken from the affected leg we observed severe hematomas, which was in one case complicated by an abscess. Once we converted to the open procedure and in one patient endoscopic preparation led to a small vein injury. When the vein was harvested from the opposite leg no complications occurred.The endoscopic subcutaneous saphenous vein harvesting in peripheral bypass surgery with a special video-assisted instrumentarium is feasible. The cosmetic advantages of this procedure are associated with high costs and a long operating time. Although we were not able to demonstrate a reduction of wound complications in our patients, the endoscopic vein harvesting in peripheral bypass surgery should be considered a very promising procedure. Nevertheless we cannot recommend the method for a wide clinical use at this time.