GSI SAPHENOUS VEIN HARVEST
GSI's ENDOSAPH™ vein harvest system consists of the SAPHfinder™ balloon dissector, the SPACEKEEPER™ retractor and the GSI Hook and Fork dissectors. This innovative system, utilizing balloon dissection technology for the gentle creation of an endoscopic operative space, is used in minimally invasive harvesting of the saphenous vein. LAPAROSCOPY.COM feels that ENDOSAPH™ has the potential to become a standard in minimally invasive harvesting of the saphenous vein.
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The saphenous vein can be harvested through a few small incisions, offering patient benefits such as decreased wound morbidity and decreased pain, potentially resulting in shorter healing time, earlier time to ambulation, and less patient discomfort in comparison with traditional open surgery.
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The ENDOSAPH™ system utilizes balloon dissection technology to provide a gentle means of creating an operative working space above the saphenous vein. The small tip of the balloon dissector is designed to straddle the vein, optimizing instrument-to-vein interface and reducing the likelihood of vein trauma. The tip also allows the surgeon easy maneuvering around side branches.
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A 5 mm, 30 degree endoscope is inserted into the SAPHfinder™ balloon dissector to allow visualization of the vein for precise tracking of the saphenous vein and proper balloon positioning.
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A view of the vein from the SAPHfinder™ balloon dissector tip is shown here.
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Once fully inserted, the balloon is inflated with saline causing gentle separation of the tissue planes to create a clean operative space. Once the balloon is filled, the dissection is complete. The balloon is then emptied by opening the suction outlet to completely evacuate the fluid. The SAPHfinder™ balloon dissector is then removed.
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The endoscope is removed from the SAPHfinder™ balloon dissector and inserted into the SPACEKEEPER™ retractor. The retractor is inserted into the dissected space to maintain the operative area. The distal hood of the retractor is designed to be self-retaining, minimizing the manual effort required to keep the retractor in position and facilitating two-handed instrument manipulation.
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The reusable Hook and Fork dissectors are used to harvest the vein from its surrounding tissue bed. The slim profile of these instruments improves handling and visualization in the M.I.S. environment.
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The saphenous vein is dissected from the surrounding tissue and the vein tributaries are clipped and divided, until the desired length of vessel has been completely harvested from its bed.
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Once the required length of vein has been harvested, the cavity is suction irrigated with saline and inspected under endoscopic visualization to ensure adequate hemostasis. The incisions are closed in the usual manner.
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Laparoscopy.com would like to thank Margaret Dreyfus from GSI for their video contribution entitled Endoscopic Saphenous Vein Harvest with the GSI. ENDOsaph (TM) is a registered product of General Surgical Innovations. For further information regarding ENDOsaph (TM), please contact Margaret Dreyfus.
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