Endoscopic vein-graft harvesting in coronary artery bypass surgery: Tips and tricks.

Despite increased use of arterial grafts, the greater saphenous vein remains the most commonly used conduit in coronary artery bypass grafting. The use of less invasive techniques for vessel harvesting has gained interest in recent years, and, many studies have reported that endoscopic vein-graft harvesting reduces postoperative pain, the incidence of wound complications, and the length of hospital stay, as well as eliminating the need for a large longitudinal incision. Over the past decade, our cardiac surgery department has gained considerable experience (>1000 cases) with this endoscopic approach.  In this video tutorial, we demonstrate our endoscopic techniques for saphenous vein-graft harvesting using two widely used devices: the VirtuoSaph Endoscopic Vein Harvesting System from Terumo (Tokyo, Japan), an open tunnel system, and the VasoView System from Maquet Cardiovascular (Rastatt, Germany), a closed tunnel system.