Endoscopic saphenous vein and radial harvest: state-of-the-art.

Abstract

Over the past decade, there has been an increased adoption of minimally invasive techniques for saphenous vein and radial artery procurement during coronary artery bypass surgery, albeit concerns have been raised about the potential detrimental effects of the endoscopic approach when compared with the conventional 'open' technique. The aim of the present review is to analyse the current available techniques and evidence about the impact of an endoscopic approach on conduit quality and clinical outcomes. At present, the available techniques for endoscopic vessel harvesting can be based on a sealed or non-sealed concept, for both saphenous vein and radial artery procurement. Despite the proven advantages of a minimally invasive approach in terms of reduced incidence of wound complications, pain reduction and improved cosmetic results, some studies questioned the impact of this technique in terms of potential graft damage, thus impairing the longevity of the graft itself. Endoscopic conduit harvesting can be performed safely and effectively with the currently available techniques, albeit a careful knowledge of the pitfalls of each technique is mandatory. Since there is ample evidence in literature that a minimally invasive approach for saphenous vein and radial artery procurement is not associated with an increased risk of graft damage and related failure in the mid-long term, the endoscopic technique should be adopted as the approach of choice for saphenous vein and radial artery harvesting in coronary artery bypass graft surgery.