How to Harvest a Saphenous Vein

The saphenous vein, which runs inside the leg from the ankle to the groin, can be harvested for use in coronary artery bypass graft surgery as a detour around arterial blockages. Removal of this large vein will not adversely affect the leg, although swelling can occur. There are two ways to harvest the vein. Endoscopic harvesting is the most commonly used approach because it is minimally invasive compared with traditional open harvesting, which requires a long incision. Endoscopic harvesting reduces postoperative pain and infection and shortens the hospital stay, according to a Duke University Medical Center study comparing the two procedures.

Instructions

Prepare the Vein

• 1

  Administer general anesthesia. Harvesting a saphenous vein endoscopically usually takes about 2 to 3 hours in the operating room while you are asleep, according to Sutter Heart & Vascular Institute.

• 2

  Make a 2-cm incision at the groin. Identify the saphenous vein position. Dissect the tissue surrounding the vein until the adventitia--the connective tissue surrounding the artery--is exposed.

• 3

  Make another incision, also about 2 cm long, in the knee area.

• 4

  Insert an endoscope into the groin-area incision. A surgeon will use this thin scope, which has a small camera on the end, to look at the saphenous vein and help guide removal.

• 5

  Inflate a balloon attached to the endoscope. As the surgeon moves the endoscope alongside the vein, a tiny balloon is inflated and deflated every 2 cm. This helps cut the tissue around the vein and any side branches of the vein.

Remove the Vein

• 6

  Continue to move the endoscope toward the knee. On reaching the knee, the camera is removed and a dissector tool is introduced through one of the previously made incisions to cut the vein from the tissue.

• 7

  Remove the vein. The surgeon will pull the freed vein out through the incision near the knee.

• 8

  Stitch the incisions and wrap the leg. Tight compression is needed to prevent bleeding. The harvested saphenous vein is now ready for use, mostly commonly in coronary artery bypass graft surgery but also for other types of bypass surgery.

• 9

  Watch for signs of complications. If the sites of incision become infected you may notice redness, pain, swelling, excessive bleeding or discharge, chills and fever, color changes in your leg, numbness or a cold leg, shortness of breath, chest pain, cough, dizziness, or a swollen, red or warm calf.