How I do it: Endoscope-assisted in situ arterial reconstruction of the lower limb

Abstract

Arterial reconstruction with greater saphenous vein (GSV) is a frequently performed vascular surgery technique for revascularization of chronic limb threatening ischemia. Surgeon variations of the procedure are common and aim to balance patency, limb salvage, complications, hospital resources and technical feasibility. This paper describes a minimally invasive revascularization option using endoscope assistance for in situ GSV-arterial bypass in infrainguinal occlusive disease. It highlights patient selection, operating room set up, instrument details and procedure strategies that facilitate use of this technique. The development and refinement of minimally invasive techniques in lower extremity arterial bypass is critical to reduce wound complications and improve limb salvage outcomes in patients.