Endostripping: A New Minimally Invasive Technique for Limited Stripping of the Greater Saphenous Vein

Abstract

Objective:

To describe a new technique for limited stripping (in the thigh) of the greater saphenous vein (GSV) to avoid painful postoperative haematomas.

Design:

Pilot study.

Setting:

General Hospital Linz, Second Surgical Department, Linz, Austria.

Patients:

Sixteen patients undergoing primary varicose vein surgery for varices on the long saphenous vein. CEAP clinical stage: C2 (n = 12), C3 (n = 4).

Intervention:

Removal of the GSV from the thigh by endoscopic dissection with electrocautery division of the main tributaries. Phlebectomy for varices in GSV tributaries.

Main outcome measures:

Clinical assessment of the extent of haematomas and cosmetic appearance.

Results:

Fifteen of 16 operations were completed as intended without any technical problem. In one case conversion to conventional stripping was required due to adhesion of the saphenous vein to a previous operation scar in the thigh. The median total operation time for one limb was 57 min. A postoperative haematoma occurred in only one patient. There was no additional postoperative complication.

Conclusion:

Endostripping is a new technique for stripping of the GSV and reduces postoperative haematoma. It can be performed in a reasonable operation time and is safe. The value of this technique should be assessed in clinical trials.