Maquet VASOVIEW 7 Training Manual Download Page 30

|

 30

ENDOSCOPIC VESSEL HARVESTING

 | 

MAQUET Medical Systems USA 

VASOVIEW 7 | Training Manual | English | v1 
Copyright MAQUET Gmbh

The OR staff plays an integral part in the VASOVIEW EVH 
system procedure. It is crucial that the OR staff understands 
how the instrumentation and equipment are used, as well 
as the steps of the procedure, in order to create a cohesive 
team. The OR staff should be properly trained on the 
endoscopic vessel harvesting procedure as well as on the 
VASOVIEW system being used. If the cardiovascular OR staff 
is not familiar with the videoscopic equipment, it is suggested 
that the manufacturer’s local field representative also 
provide additional in-services. Equipment issues should not 
complicate the endoscopic procedure. All equipment should 
be tested and in good condition prior to beginning the case.

As with any new procedure, patience is required during the 
learning phase. Allow extra time for the OR staff and the ope-
rator during the first several procedures.

circulating nurse responsibilities

Knowing and understanding each component of the video 
setup is important for the circulating nurse, as the nurse is the 
primary troubleshooter once the procedure has begun. (See 
Troubleshooting Section)

Turn on all components to the video system, including those 
that may not be used. Once the various cords are handed off 
from the sterile field to the OR staff person in the non-sterile 
OR field, the following tasks are completed.

 Connect the camera cable to the camera box. The color 
bars are replaced by a clear image that is visible on the 
screen. Note that the light source settings—manual and 
automatic—correlate with the camera box settings, as do 
shutter controls and gain buttons. (Check with the video 
vendor for the proper settings.)
 Connect the fiber optic cable to the light source. Place the 
unit in the standby mode until the procedure begins. Be 
sure that the fiber optic cable is not resting against the 
patient or sterile drapes unless in the standby mode. There 
is potential for fire due to the intensity of the light. During 
this procedure, it may be necessary to increase the light 
intensity. Frequently, the light source unit can be set to 
manual for adjustment of the light intensity. The “gain” 
button generally boosts the light even further.
 Connect the insufflation tubing to the unit, verify settings, 
and place in standby mode until CO

2

 is needed.

 Connect the bipolar cables to the generator and verify the 
generator settings. 

nurSing cOnSidEraTiOnS                                                                  

Summary of Contents for VASOVIEW 7

Page 1: ...VASOVIEW 7 Training Manual English v1 Copyright MAQUET Gmbh Training Manual VASOVIEW 7 Endoscopic Vessel Harvesting System...

Page 2: ...t judgement of the medical professional performing the procedure VASOVIEW 7 Training Manual MAQUET has a strong history pioneering and advancing endoscopic vessel harvesting systems The VASOVIEW 7 xB...

Page 3: ...on 13 Branch Cauterization and Transection 16 Optimizing Visualization 19 Guidelines for Safe and Effective Use 20 BiSECTOR Bipolar Ligating Forceps Running the Vein 21 Distal Transection and Ligation...

Page 4: ...nsecting Branches Insert the VASOVIEW 7 Harvesting Cannula to cauterize and transect branches using the BiSECTOR Bipolar Ligating Forceps Enhanced Visualization For enhanced visualization during vesse...

Page 5: ...the radial artery pedicle and expose the branches Using the BiSECTOR tool cauterize and transect branches Running the Vessel Deploy the C Ring from the VASOVIEW 7 Harvesting Cannula engage the radial...

Page 6: ...Video Monitor Light Source Insufflator Insufflator tubing CO2 Source Fiber Optic Cable with appropriate Scope Adaptor End Camera compatible to Endoscope 7 mm Extended Length Endoscope 7 mm Endoscope...

Page 7: ...t should be checked for damaged fiber optics To do this hold one end toward a direct light source and look into the other end If it illuminates with no more than one third of the area grayed the cable...

Page 8: ...d the knee area Once the intended incision site is identified mark the area with a surgical marker The saphenous vein can usually be found by using anatomical landmarks For morbidly obese patients an...

Page 9: ...tor etched on the endoscope shaft Figures 2 and 3 Insert the endoscope with attached Dissection Tip through the BTT Ensure that the Endoscope Seal is on the BTT it comes packaged with this seal attach...

Page 10: ...dyle Make a 2 cm incision along the posterior border of the tibial epicondyle Figure 7 Above the knee Make a 2 cm incision in the thigh where the vein lies in the groove between the sartorius and grac...

Page 11: ...nsert the Dissection Tip into the space created and place it onto the anterior surface of the saphenous vein Note on the video monitor the color of the vein and the surrounding yellow fatty tissue It...

Page 12: ...d can be used to inflate the balloon on the BTT Inflate the balloon with the minimal amount of air needed to create an adequate seal 0 25 cc s of air If there is obvious leakage around the incision us...

Page 13: ...flation aids the dissection by enabling constant visualization reduces bleeding and helps maintain a working space Mastery of the dissection will enable clear exposure and easy access for branch caute...

Page 14: ...anipulation 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...

Page 15: ...sue that is still adhered Figure 18 When a branch is encountered dissect it with short controlled gentle probes with the Dissection Tip Con tinue until all branches are adequately exposed to facilitat...

Page 16: ...handle of the VASOVIEW 7 Harvesting Cannula The endoscope is secured with an audible click locking it into place Figure 21 Attach the Bipolar Cord to the VASOVIEW Harvesting Cannula Ensure that the Bi...

Page 17: ...de Rotate the BiSECTOR tool manually to orient the blade upward for ease of visualization and branch capture Figures 23a 23b When the branch is captured rotate the BiSECTOR tool away from the vein the...

Page 18: ...my to further expose the branch Set the bipolar generator wattage according to the type of bipolar generator being used Refer to the VASOVIEW 7 xB Endoscopic Vessel Harvesting System Instructions for...

Page 19: ...of the Harvesting Cannula If the distal lens of the endoscope becomes obscured by blood or fat use the integrated endoscope wash feature Fill the 5 cc syringe with saline and attach it to the blue Sc...

Page 20: ...vessel branch cauteri zation and transection working back towards the incision If branches prohibit advancement of the Harvesting Cannula it may be less traumatic to the vein to perform vessel branch...

Page 21: ...f the vein Externalize the vein through the stab wound and divide it under direct vision per surgical protocol Figure 30 Allow the harvested vein segment to retract back into the tunnel Ligate the ter...

Page 22: ...f the vein for vessel preparation Measure the vein to ensure adequate length for the bypass grafting Figure 31 If additional length is needed further dissection can be carried out through the same inc...

Page 23: ...assembly information see the Product Assembly section of the Endoscopic Vessel Harvesting of the saphenous vein portion of this manual page 9 Attach the 7 mm Extended Length Endoscope to the camera co...

Page 24: ...under wrist Note the time of tourniquet deployment Generally tourniquet time is kept under one hour ENDOSCOPIC DISSECTION The radial artery is dissected as a pedicle with the accompanying venae comit...

Page 25: ...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...

Page 26: ...e settings differ by type of generator The fascia should be released from the distal forearm to the mid or proximal forearm Figure 39 BRANCH CAUTERIZATION AND TRANSECTION Once the fasciotomy is comple...

Page 27: ...ures without a tourniquet the radial pedicle should be clamped at the wrist with a soft bulldog type clamp prior to proximal division This is intended to keep the pedicle from bleeding into the tunnel...

Page 28: ...onal hemostasis Procedure Using a Tourniquet Deflate the tourniquet and note the tourniquet time Check pulse oximetry on the digits to ensure adequate perfusion to the hand The radial artery is prepar...

Page 29: ...SOVIEW 7 Endoscopic Vessel Harvesting System kit to identify the location and the length of the vessel harvested A sticker is in cluded for the patient s hospital record and a card is included for the...

Page 30: ...primary troubleshooter once the procedure has begun See Troubleshooting Section Turn on all components to the video system including those that may not be used Once the various cords are handed off fr...

Page 31: ...vein harvesting is completed and to simplify the general set up Sterile items Components of the VASOVIEW 7 xB EVH System kit VASOVIEW Harvesting Cannula with BiSECTOR tool and C Ring Short Port BTT w...

Page 32: ...fragile than shorter or larger diameter endoscopes It is recommended that the endoscopes be kept in the instrument tray available through MAQUET Cardiovascular More detailed instructions can be found...

Page 33: ...on tunnel wall Remove scope and clean it externally Use scope washer within the Harvesting Cannula to clean the lens Endoscope Fogging Use anti fog solution on the end of the endoscope only with the...

Page 34: ...both suture ends be tween the thumb and index finger as shown Step 2 Take the shortest suture tail in front of the 2 sutures forming a complete circle around the index finger Step 3 Take the shortest...

Page 35: ...OVIEW 7 Training Manual English v1 Copyright MAQUET Gmbh Step 5 Pull short and long strand to tighten knot Step 6 Pull short strand and one of the 2 strands to tighten knot securely Remember one of th...

Page 36: ...the knot is secure cut the short tail leaving 2 to 3 mm of suture Do not cut right next to the knot Step 8 Thread the knot pusher and advance knot and knot pusher into insufflated tunnel Push the knot...

Page 37: ...osition 16 When performing radial artery harvesting the radial artery harvesting procedure should be performed prior to placing the patient on cardiopul monary bypass 17 Do not touch the coagulating s...

Page 38: ...38 ENDOSCOPIC VESSEL HARVESTING MAQUET Medical Systems USA VASOVIEW 7 Training Manual English v1 Copyright MAQUET Gmbh...

Page 39: ......

Page 40: ...s on patient mobility and wound management solutions GETINGE pro vides solutions for infection control within healthcare and contamina tion prevention within life sciences MAQUET specializes in soluti...

Reviews: