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Minimal trauma radial artery harvesting using a new reusable endoscopic retractor and tissue welding technology
Mani Arsalan, Alexander Meyer, Johannes Blumenstein, Sina Schmidt, Heike Baumgarten, Thomas Walther, Jörg Kempfert.
Kerckhoff Clinic, Bad Nauheim, Germany.

OBJECTIVE: The percentage of endoscopic vessel harvesting is rising since it was introduced 1997. One problem still preventing further increase of this minimal invasive technique are cost issues.
Therefore a reusable retractor Mi-Trak combined with disposable Thermal Ligating Shears TLS2 (Microline Surgical, USA) was developed. Additionally to the cost aspect this device is slimmer in its design compared to other radial artery harvesting retractors. We report our very first series of harvesting procedures performed with this new device combination.
METHODS: We performed 20 endoscopic radial artery harvestings with the Mi-Trak retractor and the TLS2 Thermal Ligating Shears. Harvesting time, postoperative bleeding, incision and graft length were measured.
RESULTS: All radial artery harvestings could be performed without a counterincision or conversion to open technique. The harvesting time and graft length were comparable to data reported for other endoscopic radial artery harvesting devices. Incision length was about 2cm. 24 hour postoperative bleeding was below 20ml.
CONCLUSIONS: Using the combination of a reusable and disposable device we could show that radial artery graft harvesting could be performed safe with reduced cost. Due to the slimmer design of the retractor, harvesting could be performed through a very small single skin incision and tissue tunnel. This reduces possible tissue trauma to a minimum of about 1cm around the radial artery with very low bleeding. This “more minimal invasive” technique neither affects harvesting time nor graft length.

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