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Endoscopic Vein harvesting for CABG treatment

Endoscopic Vein Harvesting (EVH) is a surgical technique used in Coronary Artery Bypass Grafting (CABG) procedures. CABG involves creating new pathways for blood to flow around blocked or narrowed coronary arteries by using blood vessels, typically veins taken from the leg. Traditional vein harvesting involves making a long incision in the leg, but EVH is a minimally invasive approach using an endoscope, a thin, flexible tube with a camera and light source, to harvest the vein. Here's a detailed overview of the Endoscopic Vein Harvesting process:

1. Preoperative Assessment:

  • Patients are evaluated to determine the suitability of EVH based on their medical history, vascular condition, and the need for CABG.

  • The surgeon may assess the quality and size of the veins in the leg to ensure they are suitable for grafting.

2. Anesthesia:

  • Before the surgery, the patient is administered general anesthesia to induce a state of unconsciousness and eliminate pain during the procedure.

3. Incision and Trocar Placement:

  • A small incision, typically about 1-2 centimeters, is made near the knee or ankle.

  • Trocars (tubular instruments used to insert the endoscope and other tools) are inserted through the incision to provide access to the vein.

4. Endoscopic Vein Harvesting:

  • The endoscope is inserted through one trocar, allowing the surgeon to visualize the vein.

  • Additional trocars may be used to introduce specialized instruments for dissection and separation of the vein from surrounding tissues.

  • Carbon dioxide gas may be used to inflate the space around the vein, providing a clearer surgical field.

5. Vein Dissection and Harvesting:

  • The surgeon uses endoscopic tools to carefully dissect and free the saphenous vein or another suitable vein from its surrounding tissues.

  • The vein is then removed through a small incision, leaving minimal scarring compared to traditional open techniques.

6. Closing Incisions:

  • After the vein is harvested, the small incisions are closed with stitches or surgical staples.

  • Sterile dressings are applied to the incision sites.

7. Postoperative Care:

  • Patients are monitored closely during the initial recovery period.

  • Pain management and wound care are provided to ensure proper healing.

Advantages of Endoscopic Vein Harvesting:

  • Reduced trauma: Smaller incisions lead to less tissue damage and postoperative pain.

  • Quicker recovery: Patients may experience a faster return to normal activities compared to traditional vein harvesting.

  • Improved cosmetic outcomes: Smaller incisions result in less noticeable scars.


  • While EVH has become widely adopted, some surgeons may still prefer or choose to perform open vein harvesting in certain cases.

  • Patient-specific factors, including the presence of peripheral vascular disease or previous vein harvesting procedures, may influence the choice of technique.

It's essential for patients to discuss the specific details of their surgical plan with their cardiac surgeon to ensure that they understand the chosen approach and its potential benefits and risks.

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