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Summary of Contents for Maquet VASOVIEW 7
- Page 1 Training Manual VaSOViEW 7 EndOScOpic VESSEl HarVESTing SySTEM VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
- Page 2 This training manual for endoscopic vessel harvesting (EVH) using the VASOVIEW 7 xB is designed to provide the operator with step-by-step instructions for performing the EVH procedure. Included in this document are preoperative considerations, intra-operative technique tips, postoperative recommendations, and troubleshooting suggestions. This document is not intended to replace reading the product Instructions For Use nor is it intended to replace the independent judgement of the medical professional performing the procedure.
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Page 3: Table Of Contents
| 30 9 Case Setup | 31 10 Postoperative Procedures | 32 12 Troubleshooting | 33 13 Appendix A: Eight Steps for Tying a Ligation Loop | 34 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 4: Endoscopic Vessel Harvesting Saphenous Vein Procedure-At-A-Glance
CO gas to create a tunnel. Perform anterior, posterior and branch dissection with the Dissection Tip. cauterizing and Transecting branches Insert the VASOVIEW 7 Harvesting Cannula to cauterize and transect branches, using the BiSECTOR™ Bipolar Ligating Forceps. Enhanced Visualization... -
Page 5: Endoscopic Vessel Harvesting Radial Artery Procedure-At-A-Glance
Using the BiSECTOR tool, cauterize and transect branches. running the Vessel Deploy the C-Ring from the VASOVIEW 7 Harvesting Cannula, engage the radial artery with the C-Ring and run the length of the artery to ensure that it is completely free and that no bran- ches remain. -
Page 6: Operating Room Instrumentation And Equipment
Surgical instruments used for open harvest Video Monitor Bipolar Cord Light Source Bovie Insufflator Insufflator tubing Source Fiber Optic Cable with appropriate Scope Adaptor End Camera compatible to Endoscope VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 7: Equipment Testing
(reflects a blackened area), use a different cable. If the fiber optic cables need to be terminally sterilized, this quality-control procedure should take place prior to sterilization. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 8: Endoscopic Vessel Harvesting Procedure Saphenous Vein
If appropriate, vein mapping may be performed preoperatively. Note that the saphenous vein in its natural position lies fairly posterior in relationship to the patella. Perform skin prep according to hospital protocol. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... - Page 9 BTT. Ensure that the Endoscope Seal is on the BTT (it balance is completed. comes packaged with this seal attached). (Figure 4) Figure 2 Figure 5 Figure 3 Figure 4 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
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Page 10: Incision Site
Above the knee: Make a 2 cm incision in the thigh where the ensure easy insertion. vein lies in the groove between the sartorius and gracilis muscles. (Figure 8) Figure 6 Figure 7 Figure 8 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 11: Inserting The 7 Mm Endoscope With Attached
(Figure 9) Advance the endoscope approximately 4 cm, then slide the BTT through the incision site and into the previously Figure 9 dissected space. (Figure 10) Figure 10 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 12: Co 2 Insufflation
10 – 12 mmHg, and the tubing is connected to the BTT and the insufflator. Also, check the CO tank to ensure that it is in the open position, with an adequate amount of . (See Troubleshooting Section) VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 13: Endoscopic Dissection
To ensure the best results, follow these basic three steps which are described on the following pages: Step 1: Anterior Dissection Step 2: Posterior Dissection Step 3: Branch Dissection Figure 13 Figure 14 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... - Page 14 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. Figure 16 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
- Page 15 External manipulation by your free hand will aid dissection by bringing the tissue or branches to the Dissection Tip. As experience level increases, this will become even more beneficial. Figure 17 Figure 18 Figure 19 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
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Page 16: Branch Cauterization And Transection
ENDOSCOPIC VESSEL HARVESTING MAQUET Medical Systems USA brancH cauTEriZaTiOn and TranSEcTiOn The VASOVIEW 7 Harvesting Cannula is used for branch cauterization and transection. The design of the instrument aims the endoscope, BiSECTOR™ Bipolar Ligating Forceps, and C-Ring in one direction, allowing easy vein protection and branch transection. - Page 17 Figure 22b Cauterize with the BiSECTOR tool as necessary to achieve hemostasis, ensuring that the blade is not extended during spot cautery. Figure 23a Figure 23b Figure 24 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
- Page 18 Set the bipolar generator wattage according to the type of BiSECTOR tool to make windows. bipolar generator being used. Refer to the VASOVIEW 7 xB Sharp dissection can be performed using a cutting action. Endoscopic Vessel Harvesting System Instructions for Use for specific generator cautery settings.
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Page 19: Optimizing Visualization
MAQUET Medical Systems USA ENDOSCOPIC VESSEL HARVESTING 19 | OpTiMiZing ViSualiZaTiOn The VASOVIEW 7 also provides distal insufflation at the site of branch ligation. Remove the CO source from the BTT Insufflation Port; a one-way valve is designed to maintain the insufflated tunnel during this step. Attach the source to the Distal Insufflation Port on the Harvesting Cannula. -
Page 20: Guidelines For Safe And Effective Use
Cannula when not in use. (Figure 27) Try to keep the C-Ring with the vein in place in the center of the tunnel at all times. (Figure 27) Figure 26a Figure 26b Figure 27 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 21: Running The Vein
(Appendix A shows the steps for creating a ligation loop.) Figure 28 Figure 29a Figure 29b Figure 30 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 22: Vein Removal And Preparation
Flush and prepare the vein according to standard protocol. Figure 31 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 23: Endoscopic Vessel Harvesting Procedure Radial Artery
Insert the endoscope with attached Dissection Tip through the BTT. Ensure that the Endoscope Seal is on the BTT. (The BTT is packaged with the Endoscope Seal attached.) (Figure Figure 32 Figure 33 Figure 34 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 24: Incision And Tourniquet Deployment
Extend the forearm, placing a rolled towel under wrist. Note dure, the fascia will be released, opening the tunnel.) the time of tourniquet deployment. Generally tourniquet time is kept under one hour. Figure 35 Figure 36 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... - Page 25 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 38b VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
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Page 26: Fasciotomy
Instructions For Use (settings differ by type of generator). The transected. fascia should be released from the distal forearm to the mid or proximal forearm. (Figure 39) Figure 39 Figure 40 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 27: Transection And Retrieval Of The Radial Artery
(Figure 41) Transect and ligate the radial artery at the wrist area using standard protocol. Note the anatomical orientation of the artery for proper cannulation of the artery for vessel preparation. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 28: Hemostasis And Conduit Preparation
The radial artery is prepared in the usual fashion per hospital protocol and operator preference. Figure 42 Figure 43 Figure 44 Figure 45 VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 29: Documentation
ENDOSCOPIC VESSEL HARVESTING 29 | dOcuMEnTaTiOn Use the forms included in the VASOVIEW 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 patient. -
Page 30: Nursing Considerations
Connect the insufflation tubing to the unit, verify settings, and place in standby mode until CO is needed. Connect the bipolar cables to the generator and verify the generator settings. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 31: Case Setup
Determine the best location for OR equipment (OR tables, perfusion, video tower and anesthesia Components of the VASOVIEW 7 xB EVH System kit: equipment) the day before the case to eliminate confusion on - VASOVIEW Harvesting Cannula with BiSECTOR™ tool and the day of surgery. -
Page 32: Postoperative Procedures
Designate someone to restock the cart. Consider making one person the resident expert with the VASOVIEW system. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 33: Troubleshooting
Roll the tunnel externally to remove irrigation Remove scope and clean it externally. and re-insert the BTT and continue with insufflation. Use scope washer within the Harvesting Cannula to clean the lens. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... -
Page 34: Appendix A: Eight Steps For Tying A Ligation Loop
Step 4: Grasp the short strand and pull through the circle and begin process over, wrapping short strand a total of 5 times in the circle. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh... - Page 35 Pull short strand and one of the 2 strands to tighten knot securely. Remember, one of the strands will tighten the knot and one will advance the knot. VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
- Page 36 (Push the knot to the ligation point and cinch the suture around the vein. The suture is secure and tight when the vein has an hourglass appearance.) VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
- Page 37 The VASOVIEW 7 mm Extended Length Endoscope with Dissection Tip is indicated VASOVIEW 7 xB system is sterile unless the package is damaged or opened. The method of steri- for visualization of a surgical cavity and dissection in endoscopic procedures and other minimally lization is gamma irradiation.
- Page 38 | 38 | ENDOSCOPIC VESSEL HARVESTING MAQUET Medical Systems USA VASOVIEW 7 | Training Manual | English | v1 Copyright MAQUET Gmbh...
- Page 40 45 Barbour Pond Drive patient mobility and wound management solutions. GETINGE pro- vides solutions for infection control within healthcare and contamina- Wayne, NJ 07470 tion prevention within life sciences. MAQUET specializes in solutions, www.maquetusa.com therapies and products for surgical interventions, interventional cardi- ca.maquet.com ology and intensive care.
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