Abstract
We have performed subfascial endoscopic perforator vein surgery(SEPS)for 36 patients, 49 limbs with primary varicose vein in the great saphenous vein since September 1997.
Incompetent perforators were examined by ascending phlebography and duplex scanning. In performing SEPS, we have developed our own system aiming at minimally invasive surgery. After exsanguinating with Esmarch tourniquet and blocking circulation with a pneumatic tourniquet 300mmHg, SEPS was performed using a 2mm endoscope and 1.5 mm electric cautery by 2-point puncture on the medial aspect of the lower leg in the first half of the cases, and using KTP Laser by a system whereby the procedure can be done coaxially with a 3 mm endoscope by 1-point puncture on the medial aspect of the lower leg in the second half of the cases. The visual field was secured by carbon dioxide gas insufflation.
The success rate of SEPS was 91.9% for the first half and 100%for the second half. No complication occurred in any cases. Symptoms disappeared or improved markedly. No recurrence of varix has been found up to the present. Our SEPS is minimally invasive and capable of treating incompetent perforators for sure and satisfying patients from the cosmetic viewpoint.
Particularly, division by one point puncture using KTP Laser enabled us to perform the surgery easily in a short time.
