Day Surgery for Primary Varicose Veins in an Office Setting

Abstract

To evaluate the safety and limits of ambulatory surgery in an office setting, four hundred and forty eight patients with 526 involved limbs (10 limbs with active ulcer included) treated during a five–year period were investigated. The technique of perforate invaginate (PIN) stripping was used to remove long saphenous vein under femoral nerve block anesthesia supplemented where necessary with tumescent local anesthesia (TLA). Thirty–four patients had both long and short saphenous vein insufficiency. Full–length stripping of long saphenous vein was performed in 35 limbs. All preoperative ulcers were completely cured between 0.9 and 4.5 months after surgery. Subcutaneous bleeding at the groin occurred in one case just after operation and emergency transportation to another hospital was needed. Except for this case, no consultations took place after the patients returned home. Complete day surgery was possible in 98.9% of operated patients. Only six patients actually required admission because: 1) they live far from our clinic (4 patients), 2) postoperative lymphangitis (1 patient) and 3) inguinal subcutaneous bleeding (1 patient—described above). These results suggest that this technique can be safely used in an office setting regardless of the severity of varicose veins and is preferred by patients. Nevertheless, it is important to have a cooperative relationship with other hospitals in order to respond to postoperative complications.