Hayashi Ichiro, Kashima Ichiro, Yoshikawa Eiji
38074 Department of Cardiothoracic Surgery, Self-Defense Forces Central Hospital, Tokyo, Japan.
84180 Department of Cardiothoracic Surgery, Misyuku Hospital, Tokyo, Japan.
Innovations (Phila). 2020 Jan/Feb;15(1):81-84. doi: 10.1177/1556984519886549. Epub 2019 Dec 26.
There are substantial data in support of improved patency using the no-touch (NT) saphenous vein (SV) harvesting technique. However, wound complications correlated with such are more significant than those associated with the skeletonized technique. To solve this, we introduced the use of the electrothermal bipolar vessel sealing device via small incisions. In this study, a cordless retractor with a built-in LED light source was utilized. The NT-SV graft was harvested with a pedicle of surrounding tissue approximately 5 mm in size and attached to the main trunk. The intima, tunica media, adventitia, and vasa vasorum appeared normal by histological analysis. Our technique combines the potential advantages of a minimally invasive endoscope approach using bipolar electrothermy and the improved patency of a NT-SV.
有大量数据支持使用非接触式(NT)大隐静脉(SV)采集技术可提高血管通畅率。然而,与此相关的伤口并发症比与骨骼化技术相关的伤口并发症更为严重。为了解决这个问题,我们通过小切口引入了电热双极血管闭合装置的使用。在本研究中,使用了一种内置LED光源的无绳牵开器。NT-SV移植物通过大小约为5毫米的周围组织蒂进行采集,并附着于主干。组织学分析显示内膜、中膜、外膜和血管滋养管外观正常。我们的技术结合了使用双极电热的微创内窥镜方法的潜在优势和NT-SV改善的血管通畅率。