Background:
Coronary Artery Bypass Graft (CABG) surgery is performed to treat the number one human killer, heart disease. This is one of the most common surgical procedures in the world, (about 500,000 cases a year in the US). An important part of the surgery is harvesting the vessel that will be used as a graft. This important step of the surgery is performed after opening the chest by sawing through the breast bone and then cutting the tissues around the vessel on the chest wall with electrocautery on one side then the other to release the vessel. The vessel is then grafted to the heart.

Device:
Our device enables the surgeon to harvest the vessel in a minimally invasive approach, through only a 2 inch opening on the side of the chest instead of conventional approach of cutting the chest bone, 3 times faster, and preventing potential collateral thermal damage. This device is comprised of 2 parallel scissor shaped jaws with a camera in between connected to an operating handle. These jaws use ultrasonic energy (harmonic scalpel) to cut the tissues around the vessel to harvest it. The ultrasonic energy, prevents high temperature generated by the regular cautery, a potential for collateral thermal injury. The dual cutting jaws adds speed and accuracy. The dual acting scissor mechanism has never been available before for any surgical application.

Device operation:
The surgeon enters the tip pf the device into the chest through the small hole on chest side. Each jaw is placed on one side of the vessel guided by the device’s camera. The distance between the jaws is adjustable according to the size of the vessel. Once activated, the surgeon advances the device along the vessel. On each advance (about an inch) the surgeon manually closes the 2 jaws simultaneously and cuts the tissues along the vessel, therefore releasing it from the tissue attachments around.

The camera between the jaws provides a high definition and X20 magnified view on the monitor instead of only X3.5 magnification available by ordinary surgical telescopes in open approach and direct vision. This high resolution view, increase the precision of the harvest process, avoids missing branches and unnecessary bleeding.
The harvest time using this device shortened from 30-40 minutes in fully exposed open chest, and 60-70 minutes in other minimally invasive techniques to 7-10 minutes using this device.

Benefits:
By using this device, the surgeon achieves efficiency by reducing the harvest time, accuracy by magnified close view and safety by using a safer energy source. These facts translate to better patient outcome, lower cost and improving the quality of the surgery.