Start the longitudinal skin incision where the greater saphenous vein (GSV) terminates in the femoral vein. Expose the saphenofemoral junction (SFJ) step by step and divide its branches between ligatures. Clamp the GSV just distal to where it terminates in the deep femoral vein and secure the central stump with a suture ligature. Expose the GSV distad to the required length of the graft. Clamp and divide the GSV distally and secure the distal stump with a simple ligature. Mark the harvested GSV segment at one end with a coronary bulldog clamp (venous valves reversed) and place it in HTK (Bretschneider) solution until further use. Once hemostasis has been achieved close the wound in layers. Apply a dry dressing.
Tips:
1. Do not stretch the harvested GSV segment, as this may result in sclerosis and stenosis in the long run.
2. Flush the harvested GSV segment with heparin-saline and thus gently stretch it (not demonstrated in the video).
