Refractor apparatus for use in harvesting mammary arteries during heart by-pass surgery

摘要

Devices and methods for minimally invasive complete or partial harvesting of a vessel or vascular conduit from surrounding tissue, especially the saphenous vein for coronary artery bypass grafting, are disclosed. A system is disclosed for creating an expanded working space proximate a length of vessel to be harvested comprising an elongate tissue retractor (12) having distal and proximal ends, and at least one support structure (16, 18, 80) comprising a frame member (16, 18) having an open region (60) appropriately sized for the passage of endoscopic surgical instruments, a retaining portion (26) configured to be releasably fixed to the elongate tissue retractor (12) proximate the proximal end of the elongate tissue retractor (12), and a base portion (28) located opposite the retaining portion (26) of the frame member (16, 18). In preferred method of the present invention, a system in accordance with the teachings of the present invention is inserted into a working space proximate the length of vessel to be harvested. Once in place, the system is used to gently dissect overlaying tissue from the length of vessel and to create an expanded working space proximate the vessel. Surgical tools can then be inserted into the expanded working space through an open region provided in a support structure to completely harvest the length of vessel from the surrounding tissue.