Tendon-graft harvest using endoscopic guidance.

Traditional methods for harvesting tendon grafts using direct visualization commonly require multiple minute incisions or possibly a single incision if blind dissection by means of a tendon stripper is acceptable. Endoscope-assisted tendon-graft retrieval also can be limited to a solitary incision but, simultaneously because of the advantage of continuous visualization, permits a more precise and safer dissection as regards important contiguous anatomic structures. Upper extremity tendons can be readily manipulated by this technique, but at least with currently available equipment the more rigid deep fascia of the lower extremity so far has made such an adaptation cumbersome. The value of the surgical endoscope as an adjunct not only for tendon-graft harvest but perhaps someday for minimally invasive tendon transfer or tenolysis is encouraging.