Patients who undergo heart bypass surgery actually have two procedures from which to recover.
In the past, one of those has been quite painful. It involves getting a vein graft from the leg. Recovery from this aspect of the surgery was actually the most difficult, but endoscopic vein harvesting has changed that. Instead of long incisions that create large wounds, surgeons can make two small incisions that heal much more quickly.
"We take a tunneler, a small camera. We make a small incision about 5 mm long above the knee and create a tunnel just above the saphenous vein," said Dr. Dan Van Cleve, a cardiovascular surgeon at Rush Foundation Hospital. "And then we're able to actually dissect the vein out around the surrounding connected tissue and make a long tunnel."
Dr. Van Cleve said patients are even requesting the procedure, because they have educated themselves about its benefits, which he says are considerable.
"The incidence of infection is lower. We've done over 300 patients in the two years I've been here and our incidence of wound infection in the leg is almost nonexistent, and then it also helps with rehabilitation, because patients are able to ambulate sooner. They have less pain when they walk. You know, when you ask a patient who has had a bypass procedure, they generally don't even complain about their chest incision because it's through the sterum. It's wired up nice and tight. Most patients before endoscopic vein harvesting complained more about their leg incision than they did about their sternal incision," Van Cleve said.
Van Cleve said the only time the old technique is used is in the case of an emergency or when veins in the patient's legs are unsuitable for some reason.