The presently disclosed embodiments relate to insufflation and irrigation conduits for vessel harvesting systems and methods of their use. In particular, the present disclosure relates to a system having a combined cabling for providing gases, liquids, and/or electrical power to an attached medical device and method of use.

An apparatus for harvesting a vessel from a body, includes: a cannula having a dissector for advancing along the vessel to create a tunnel, the dissector having a transparent portion; and an energy tool moveably coupled to the cannula, wherein the energy tool is configured to separate a pediculated vessel having at least a segment of the vessel and a pedicle around the segment of the vessel from surrounding tissue, and wherein at least a part of the energy tool is visible through the transparent portion of the dissector during use of the energy tool.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

Apparatus, systems, and methods for endoscopic dissection of blood vessels and control over cavity pressure within an endoscopic procedure are described herein. Apparatus, systems, and methods for harvesting of blood vessels are also described herein.

A device for vessel harvesting is disclosed. The device for vessel harvesting includes a distal housing, a dissector coupled to the distal housing, a drive element coupled to the dissector, and an actuator coupled to the drive element. The device for vessel harvesting may also include a rotatable dissector, a shaft coupled to the distal housing having a first articulation joint movable within a first plane, and a second articulation joint movable within a second plane, which is substantially perpendicular to the first plane, a barrel chain drive element coupled to the rotatable dissector, and an actuator coupled to the drive element. The device for vessel harvesting may also include a member slidably engaged to the distal tip.

A blood vessel dissecting device is disclosed, which includes at least two dissecting devices, which are inserted into a living body along a blood vessel to dissect tissue in a direction of alignment thereof with the blood vessel. The at least two dissecting devices include a first dissecting device and a second dissecting device. The first dissecting device and the second dissecting device are disposed juxtaposedly in the living body, and a branch vessel branched from the blood vessel is located between the first dissecting device and the second dissecting device.

A blood vessel dissecting device is disclosed, which includes a dissecting device which, when being inserted into a living body along a blood vessel, dissects tissue in a direction of alignment thereof with the blood vessel, and a cutting device which, when being inserted into the living body along the blood vessel, cuts tissue surrounding the blood vessel in a direction of alignment thereof with the blood vessel. The cutting device includes a main body section which is inserted into the living body and holds the tissue between itself and the dissecting device, and a cutting section which cuts the tissue held between the main body section and the dissecting device.

A blood vessel harvesting system, which harvests blood vessels in a state of being covered by surrounding tissue, includes a separating device and a display device. The separating device includes a rod portion that is inserted into a living body, an optically transparent taper-shaped separating portion that is disposed at a distal end part of the rod portion, an endoscope portion that is disposed inside the rod portion and captures an endoscope image of an interior of the living body via the separating portion, and an ultrasound transceiver portion that is disposed on an outer peripheral surface of the rod portion, irradiates the interior of the living body with an ultrasonic wave, and receives a reflected wave from the interior of the living body. The display device matches a scale of the endoscope image with a scale of an ultrasound image acquired by the ultrasound transceiver portion and simultaneously displays the endoscope image and the ultrasound image side by side on the display screen, and the display device disposes the endoscope image and the ultrasound image on the display screen such that a point in the endoscope image indicating a predetermined position in the living body matches a point in the ultrasound image indicating the predetermined position on the display screen.

A method of atraumatically hydrodissecting and maintaining endothelial function and structure of a vascular target includes forming an incision in tissue proximate one end to realize an insertion space, inserting a distal end of a cannula and/or endoscope into the insertion space and while visualizing the vascular target, ejecting a hydrodissecting fluid from the distal end of the cannula and/or endoscope to substantially separate or dissect the vascular target from the surrounding tissue, while advancing the distal end through the space as it is enlarged by the hydrodissecting fluid, to a distal target end of the vascular target. The hydrodissecting fluid is formulated to minimize or prevent formation of microthrombi in the hydrodissected vascular target. The hydrodissecting fluid is a water-based vascular graft treatment solution and can include any of a balance salt solution, a metallic salt solution, such as Plasma-Lyte® A, a vascular graft treatment solution, such as Duragraft® solution, L-Arginine, aspirin and low molecular weight heparin.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.