An instrument for manipulating a vessel in a patient includes a cannula having a lumen for providing insufflation to create a working space in the tissue of a patient, and a first manipulator for manipulating a vessel located within the working space. The first manipulator is slidably movable within the cannula from a stowed position, where the first manipulator is substantially disposed within the cannula, to a forward position, where at least a portion of the first manipulator is disposed outside the cannula. The first manipulator is rotatable when in the forward position to an extended position.