Maquet VASOVIEW 7, Training Manual, Page: 25 / 40

25 | | MAQUET Medical Systems USA | ENDOSCOPIC VESSEL HARVESTING |
VASOVIEW 7 | Training Manual | English | v1
Copyright MAQUET Gmbh
Step 1: anterior dissection
With the aid of continuous CO
2
pressure, advance the 7 mm
endoscope along the pedicle veins on each side of the radial,
avoiding any contact to the radial artery. (Figures 37a and
37b) Dissect tissue and fascia away from the veins and radial
artery, lifting the tip in an upwards direction. The lifting motion
transmits shear force against the lateral muscular fascia and
not the radial artery. Continue anterior dissection to the level
of the recurrent radial or venous plexus in the antecubital
fossa. As branches are encountered, advance past them with
as little displacement as possible.
Step 2: posterior dissection
Return the Endoscope back to the BTT port. Carefully advance
the Endoscope posterior to the radial pedicle. Begin advanc-
ing the Endoscope along the posterior aspect of the radial
artery, again avoiding contact with the radial artery. Although
anatomy varies from patient to patient, posterior branches are
likely to be encountered midway up the forearm. When bran-
ches are encountered, free enough space around the branch
to produce minimal stress to the branch as the Dissection Tip
is advanced. Continue this dissection to the level of the recur-
rent radial artery. (Figures 38a and 38b)
Step 3: lateral dissection
The purpose of lateral or branch dissection is to create
“windows” in or clear adjoining tissue from the pedicle. This is
achieved by advancing the Dissection Tip through the desired
tissue.
To begin the lateral dissection, return the Endoscope back
to the BTT port. Larger branches may require creating a
“window” through the tissue away from the pedicle creating
additional exposure of the branch for later cautery. The
final goal is obtaining a pedicle with both venae comitantes
on each side of the radial. Therefore, avoid any dissection
between these structures.
Figure 37a
Figure 37b
Figure 38a
Figure 38b