Novel harvesting technique of no-touch saphenous vein graft using THUNDERBEAT

Ishizawa, Ai; Hamasaki, Azumi; Uchida, Tetsuro; Sadahiro, Mitsuaki

doi:10.1007/s11748-019-01097-4

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…This system has proven its efficacy in harvesting SV with the no‐touch technique. In a series of 35 patients submitted for coronary bypass, safe sealing of side branches, and fewer wound complications without thermal damage to the graft, compared with electrocautery, was achieved [36].…”

Section: Discussionmentioning

confidence: 99%

“In Vitro” Evaluation of Energy‐Based Sealing of Graft Side Branches in Bypass Surgery

et al. 2023

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Introduction Our objective was to compare the in vitro efficacy of electrothermal bipolar [EB] vessel sealing and ultrasonic harmonic scalpel [HS] versus mechanical interruption, with conventional ties or surgical clips (SC), in sealing saphenous vein (SV) collaterals, during its eventual preparation for bypass surgery. Methods Experimental in vitro study on 30 segments of SV. Each fragment included two collaterals at least 2 mm in diameter. One of them was sealed by ligation with 3/0 silk ties (control) and the other one with EB (n = 10), HS (n = 10) or medium-6 mm SC (n = 10). After incorporation in a closed circuit with pulsatile flow, the pressure was progressively increased until causing rupture. Collateral diameter, burst pressure, leak point, and histological study were recorded. Results Burst pressure was higher for SC (1320.20 ± 373.847 mmHg) as compared with EB (942.2 ± 344.9 mmHg, p = 0.065), and especially with HS (637.00 ± 320.61 mmHg, p = 0.0001). No statistically significant difference between EB and HS was found, and bursting always happened at supraphysiological pressures. The leak point for HS was always detected in the sealing zone (10/10), while for EB and SC, it occurred in the sealing zone only in 6/10(60%) and 4/10(40%), respectively (p = 0.015). Conclusions Energy delivery devices showed similar efficacy and safety in sealing of SV side branches. Although bursting pressure was lower than with tie ligature or SC, non-inferiority efficacy was shown at the range of physiological pressures in both, EB and HS. Due to their speed and easy handling, they may be useful in the preparation of the venous graft during revascularization surgery. However, remaining questions about healing process, potential spread of tissue damage and sealing durability, will require further analysis.

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Section: Discussionmentioning

confidence: 99%

“In Vitro” Evaluation of Energy‐Based Sealing of Graft Side Branches in Bypass Surgery

et al. 2023

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“…However, the incidence of lower extremity incision complications is significantly higher than that of the traditional long incision method. 5 The main manifestations are lower limb pain or numbness, edema or exudation, and an increased incidence of subcrustal healing under the scar. Major complications included subscab healing, while minor complications included lower limb pain or numbness, edema or exudation, and infection.…”

Section: Discussionmentioning

confidence: 99%

“…A compression bandage was applied using an elastic bandage for 48–72 hours. 5 …”

Section: Methodsmentioning

confidence: 99%

The Short-Term Patency Rate of a Saphenous Vein Bridge Using the No-Touch Technique in off-Pump Coronary Artery Bypass Grafting in Vein Harvesting

Zhao¹,

Bu²,

Gu³

et al. 2021

IJGM

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Objective This study aimed to examine the short-term effect of the no-touch technique on the patency rate of a great saphenous vein (GSV) bridge used during off-pump coronary artery bypass grafting (OPCABG). Methods Between June 2018 and September 2020, 140 patients undergoing OPCABG, with grafts obtained from the GSV using the “no-touch” technique or the left internal mammary artery (LIMA), were enrolled in this study. The early clinical results and short-term patency rate of the OPCABG were evaluated at a three-month follow-up by comparing the patency rate of the LIMA bridge and the GSV bridge obtained by the no-touch technique. This study also analyzed the impacts of the postoperative complications of the lower limbs and the distribution area of diseased vessels on the patency rate of a GSV bridge obtained by the no-touch technique at an early stage. Results No perioperative death or adverse cardiovascular or cerebrovascular events occurred in the 140 patients undergoing OPCABG. The difference in the early patency rate between the GSV bridge obtained by the no-touch technique and the LIMA bridge was not statistically significant (95.9% vs 97.1%, p = 0.501). There was no significant difference in the patency rate between an end-to-side anastomosed venous bridge and a LIMA bridge (95.0% [248/261] vs 97.1% [136/140], p = 0.314). The overall patency rate of a no-touch vein bridge in the right coronary artery region was lower than it was in the left coronary artery region (93.8% [165/176] vs 97.9% [183/187], p = 0.049). Conclusion The no-touch technique may improve the early patency rate of a GSV bridge, and its effect is similar to that of a LIMA bridge.

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“…We have previously demonstrated that THUNDERBEAT Open Fine Jaw (TOFJ, Figure 1A; Olympus Medical Systems Corp, Tokyo, Japan), a novel hybrid ultrasonic/bipolar energy device, is useful for harvesting pedicled saphenous vein graft 5 . Moreover, this device is useful for harvesting skeletonized RGEA.…”

Section: Introductionmentioning

confidence: 99%

Harvest of the right gastroepiploic artery graft using a novel hybrid ultrasonic/bipolar energy device

et al. 2020

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Background: The right gastroepiploic artery (RGEA) is a useful in-situ graft, and skeletonization is effective to prevent spasm and achieve good patency. To harvest the skeletonized RGEA easily, ultrasonic scalpel has been widely used, but the tip shape of conventional ultrasonic device was not optimal for this procedure.Recently, a novel hybrid ultrasonic/bipolar energy device (THUNDERBEAT Open Fine Jaw [TOFJ]) has been developed and is widely used in general surgery.Surgical Technique: The operator holds forceps in left hand and TOFJ in right hand, incises the anterior layer of the omentum, and extends the incision distally along the RGEA. The side branches and satellite veins were sealed and cut. Because the tip of the TOFJ is well-designed to easily grasp and peel off the tissue, there is no need to change instruments throughout the procedure. After the dissection was advanced distally, the proximal side was subsequently dissected.Conclusions: This novel device is useful for harvesting skeletonized RGEA. K E Y W O R D S coronary artery bypass grafting, gastroepiploic artery, harvesting technique, hybrid ultrasonic/bipolar energy device, THUNDERBEAT

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Novel harvesting technique of no-touch saphenous vein graft using THUNDERBEAT

Cited by 5 publications

References 6 publications

“In Vitro” Evaluation of Energy‐Based Sealing of Graft Side Branches in Bypass Surgery

“In Vitro” Evaluation of Energy‐Based Sealing of Graft Side Branches in Bypass Surgery

The Short-Term Patency Rate of a Saphenous Vein Bridge Using the No-Touch Technique in off-Pump Coronary Artery Bypass Grafting in Vein Harvesting

Harvest of the right gastroepiploic artery graft using a novel hybrid ultrasonic/bipolar energy device

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