[Initial experience with endoscopic subfascial dissection of perforating veins in 100 interventions]

Abstract

Progress in minimal invasive surgery made us look for a new concept to treat our patients with varicosis, which is one of the most frequent operations in our department. We changed our method from an epifascial ligation to an endoscopic subfascial dissection of the perforating veins (ESDP). This method was developed and first described by Hauer in 1985 [2]. Between March 1992 and May 1993 we treated 85 patients by this method, performing ESDP on 100 legs. In most of the cases the operation is combined with a classic Babcock's procedure, although it can be done isolated. Sectioning of the perforating veins needs special instruments and must be performed in partial deprivation of blood supply, which is produced by a sterile Löfqvist roller cuff [5]. The sectioning of the perforating veins through a small incision in the medial part of the lower leg allows a dissection of all perforating veins in the medial and dorsal sections of the lower leg. The subfascial procedure reduces delayed wound healing, especially in patients with trophic skin disorders. The operation in deprivation of blood supply allows smaller and therefore cosmetically better incisions also for the other subcutaneous varices.