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OBJECTIVE: Minimally invasive video endoscopic saphenous vein harvesting (EVH) for CABG significantly reduces per operative lower limb complications and has been increasingly used worldwide.
Hematoma of the endoscopic tunnel is one of the most frequent known complications of the EVH, with occurrence rate similar to the open techniques, which is responsible for most of the disabling postoperative symptoms.
Report the initial experience of our team with the routinely use of video assisted placement of tubular vacuum drainage system in the EVH subcutaneous tunnel to prevent hematoma formation.
METHODS: Between August 2011 and July 2014 our team operated 110 consecutive patients using the EVH technique. Thigh saphenous vein segments have been preferably harvested in most cases. The VASOVIEW HEMOPRO Maquet ® system has been used in all cases following the manufacturer instructions.
A 6,4 mm tubular vacuum drainage system has been placed routinely under video assistance in the EVH tunnel at the end of the procedure in the last group of patients.
The whole series of patients was divided in three groups. Group A, first phase, includes our learning curve with the EVH tecnique, Group B, intermediate phase, both without drainage use, and Group C, third phase, with use of tubular vacuum drainage in all cases.
RESULTS: The total number of patients and the postoperative hematoma of the harvesting tunnel were respectively: 50(8%), 38(2,6%), 22(0,0%).
CONCLUSIONS: The routinely use of video assisted tubular vacuum drainage of the saphenous vein-harvesting tunnel virtually abolished the incidence of the postoperative hematoma complication in our EVH consecutive initial experience.