This is an edited Femoro-popliteal bypass operation performed for critical ischaemia:

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This patient's leg was at imminent risk of losing its blood supply and becoming non-viable. A bypass was performed to improve the circulation. The bypass conduit used was the patients own vein (Long saphenous vein).

Steps of the procedure:

1. Long saphenous vein is harvested

2. Distal popliteal artery (below the knee) is exposed and mobilised from the deep veins

3. Tendons that would otherwise compress the bypass graft are divided

4. The common femoral artery in the groin is then exposed

5. The long saphenous vein is reversed to allow the valves to be positioned in the right direction

6. An anastomosis is performed between the vein and the popliteal artery

7. The vein is then tunnelled to the groin

8. An anastomosis is performed to the common femoral artery in the groin

9. The bypass graft is then flushed out of the distal end to get rid of bubbles/ air

10. The bottom anastomosis is then completed and the bypass graft is opend

11. The wound is closed