Name: Atraumatic Hamstring Tendon Harvester
Uploaded: 2018-03-01T00:00:00Z
Channel: Arthrex
Description: Steve E. Jordan, MD, (Gulf Breeze, FL) demonstrates the Atraumatic Hamstring Harvester for use in minimally invasive hamstring harvesting techniques.

<p>Steve E. Jordan, MD, (Gulf Breeze, FL) demonstrates the Atraumatic Hamstring Harvester for use in minimally invasive hamstring harvesting techniques.</p>

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VID1-01336-EN | A | Atraumatic Hamstring Tendon Harvester

Steve E. Jordan

Human

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

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Surgical Technique Videos

Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

Atraumatic Hamstring Tendon Harvester

Today we're going to discuss the hamstring harvesting techniques. Specifically, we're going to go over the new eight traumatic hamstring harvester from Arthrex. As you can see it has an eight traumatic smooth tip, measures five by six millimeters, which is smaller than most harvesters, will allow us to take less tissue with the tendon, has a nice ergonomic switch or trigger to open and close the harvesting end. Can hear the nice click as it closes. It helps you harvest the tendon. I prefer the posterior harvesting technique. It's been shown to be faster, smaller incision with less chance of injuring the branches of the saphenous nerve. For the posterior technique, we also need the short closed harvester to go from proximal to distal to release the tendon off its distal attachment to the tibia. So we also need a 90 degree clamp. And then to deliver the tendon, we use an arthroscopic grasper and FiberTape to control it. Now we'll go over the technique. I prefer the posterior harvest technique because the tendons are so accessible in this area. The technique is quicker, less likelihood of injuring the saphenous nerve. If you prefer the anterior harvest, obviously an oblique incision might be a little better to avoid injuries to the nerve. You can still use the atraumatic harvester, but you might take extra care to release the bands because it's not sharp and releasing the fascial bands or pulleys up here. Take extra care while using a traumatic harvester for the posterior technique. I like the patient supine, the leg externally rotated, the foot supported on a small bump. My assistant holds and sometimes just retracts the redundant skin and allows me to palpate. The incision is a little more posterior than you might initially think, but it's right over the tendon, so palpate the semitendinosus tendon and make a small 1in to 2 inch incision. I'll make it a little larger today so we can see better. And I usually make a crosshatch over where I felt the tendon which helps me. And then a little higher to help closure. Okay. So we make a small incision. Dissect longitudinally. You can usually feel the fascia over the semitendinosus. Go ahead and dissect the soft tissue. You can do it bluntly or sharply. And then here we see the fascia which I'm going to divide in the direction of the tendon. So I always use my semitendinosus as a landmark. It's obviously easier to palpate because it's bigger. It's the furthest posterior. So I always used to remember the Pez Sartorius gracilis Semitendinosus Sgt Semitendinosus at the bottom. Membranaceus is going to be here. And then in a bit we're going to find the gracilis up higher under the sartorius fascia. So I like to clean it, clean the tendon, put a right angle retractor around it. Take time to identify the tendon again use a FiberTape loop. I take the loop like this. Pull it around and control the tendon. Clean a little more proximally. So the best way to load this is coming perpendicular to the tendon. I have it controlled with the FiberTape. Take it perpendicular. And this tent is not very big in this cadaver. So we just go straight up press against it on a wider tendon. It will pop in and then just close it. We then go in line with the tendon to release it in line with the tendon. As you can see it slides go straight in line with the smooth firm push. And the tendon releases. As you can see, not much muscle because of the atraumatic harvester. So that's really less bleeding. And we think less pain. Have an assistant hold the tendon and then we deploy the closed harvester quite easily by doing like this and pulling it gently into it. Now this is sharp. We've released our fascial bands distally already. Sometimes I like to take the tendon and wrap it around my finger. Use a ray tech or lap. You must get right next to the leg. That's how this harvester works, right in direct line with the tendon. What I like to do is slowly push, so we slowly push and I like to work it, give it a little slack as you work your your stripper down there. And then when we get out to the tibia, you raise your hand and hand and you can literally pull it right off the bone. So now we have a nice semitendinosus tendon with very little unnecessary tissue harvested, as you can see, with a traumatic harvester. So we've taken the semitendinosus we move up, we see the semimembranosus fascia here, sartorius fascia. We divide that and gently lift up. And that's where the gracilis lives. So we have the gracilis. Control it with the FiberTape. Again like to clean the fascial bands approximately in the. And the distal ones are right here in front of you. So it's not hard to find them. Place to a traumatic harvester perpendicular. Close it in line with the tendon and harvest.

Atraumatic Hamstring Tendon Harvester

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