Minimally invasive no touch (MINT) procedure for harvesting the great saphenous vein (GSV), endoscopic asval technique and assisted pin stripping of superficial GSV, hydrodissection-based endoscopic vein harvesting (EVH) system, venous hydrodissector, retractor and tip adapter for use with flexible cystosope and adapted cystoscope system

An endoscopic hydrodissector for atraumatically hydrodissecting a vascular target, the hydrodissector comprising:

• a handle;
• an elongate endoscopic tube attached to or integral with the handle at a proximal end of the elongate endoscopic tube with
• a working port or opening at a distal end of the elongate endoscopic tube;
• a hydrodissecting shell with a distal end and a proximal end, the hydrodissecting shell configured for attachment to an outer surface of the elongate endoscopic tube, wherein
• a fluid ejection port is arranged at the distal end of the hydrodissecting shell in fluid-flow connection to a fluid conduit or channel in an inner volume of the hydrodissecting shell that is in fluid-flow connection to a fluid supply for supplying hydrodissecting fluid for ejection from the fluid ejection port to hydrodissect and substantially separate the vascular target from tissues surrounding the vascular target, creating a substantially hydrodissecting fluid-filled space therebetween;
• wherein the working port or opening of the elongate endoscopic tube and the fluid ejection port of the attached hydrodissecting shell are inserted into an incision space formed by making an incision into the tissue proximate a proximal end of the vascular target and
• controlled to move through the incision space and create a created space by hydrodissecting to separate the vascular target from the tissues surrounding the vascular target and enlarging the created space as the elongate endoscopic tube with working port or opening and hydrodissecting shell with the fluid ejection port to traverse the created space to the distal end of the vascular target;
• and
• wherein the hydrodissecting fluid is formulated to minimize or prevent formation of microthrombi in the endothelium of the hydrodissected vascular target.