Identification and Holding of the Great Saphenous Vein in the Inguinal Region Using a Stripper and Echography

Abstract

In our hospital, identification and holding of the great saphenous vein (GSV) for high ligation in stripping are performed through a 1.5 cm or smaller surgical wound by operating on the groin while visually confirming the stripper inserted from the peripheral side. The subjects were 231 patients who underwent stripping of the GSV between December 2012 and April 2020. Cases in which this method could be performed and the presence or absence of intraoperative complications were investigated. The method was applicable in 222 patients and no artery or deep vein was damaged. It could not be performed in 3 patients with ascending thrombophlebitis and 5 patients with a short GSV reflux range. In one patient in whom the disease recurred after high ligation, tissue dissection was difficult due to the presence of a scar. A mean time of 80 seconds was required to hold and lift the GSV and apply taping from initiation of skin incision in the first 10 cases. In this method, the risk of damaging deep arteries and veins was reduced by holding the GSV under echography while observing the stripper as a landmark. This procedure may increase the safety of the surgery.