Maquet VASOVIEW 7, Training Manual, Page: 14 / 40

| 14 | ENDOSCOPIC VESSEL HARVESTING | MAQUET Medical Systems USA |
VASOVIEW 7 | Training Manual | English | v1
Copyright MAQUET Gmbh
Figure 15
Step 1: anterior dissection
Position the Dissection Tip on the anterior surface of the
vein. (Figure 15) Begin dissecting until you have reached the
desired length of vein.
Technique Tips
The Dissection Tip should be positioned between the vein
surface and the surrounding fatty tissue.
To ensure the maximum effect of the CO
2
insufflation and to
create the optimal tunnel, it is important to keep the
Dissection Tip close to the vein and not stray into the
surrounding tissue. This helps to avoid creating multiple
small spaces or pseudo-tunnels.
Use smooth, controlled, short strokes when advancing the
endoscope, allowing CO
2
to reach the tip and facilitate
dissection.
Use your dominant hand to guide the endoscope and your
free hand on the external operative area to facilitate
dissection with external manipulation. If tissue collects on
the Dissection Tip, use your free hand on the outside of the
leg to palpate the tip and dislodge the tissue. (Figure 16)
Maintain the endoscope in a position parallel to the vein.
This will help to avoid diving into the vein, thereby minimi-
zing the risk of perforation. Correct camera orientation is
necessary and should be maintained throughout the proce-
dure.
If at any point the vein is no longer visualized, retract the
endoscope until the vein is again visualized, ensure proper
camera orientation and proceed with dissection.
preventing avulsions or perforations
A perforation may occur if the vein appears to surround the
Dissection Tip. The video monitor may reveal a fine swirling
or “halo” effect. If this occurs, stop advancing and withdraw
the endoscope until the swirling effect disappears. Then
continue dissection ensuring the endoscope is in the proper
tissue plane.
Watch for anterior branches and direct the Dissection Tip
around them to prevent an avulsion.
Some branches may require some dissection in order to
allow easy passage around the branch providing minimal
branch tension.
Figure 16