It has been reported about the safety, feasibility, and excellent cure rate of SEPS for chronic venous ulcers of the C6 patients, according to the CEAP classification. Otherwise the SEPS operation is not still authorized by the national health insurance system yet in Japan. SEPS has authorized as the national advanced medical system by the Ministry of Health, Labor and Welfare in May, 2009. And the 3 institutions, including our hospital, have been authorized, and all are the members of the Society of Endoscopic Therapy for Vascular Disease.
This study was undertaken to report our latest results, and discuss about how to get the knack of SEPS for beginners.
From 1998 to 2009, we performed two port system subfascial endoscopic perforator vein surgery (TPS-SEPS) with or without superficial venous ablation (SVA) on more than 1000 limbs. In these periods, we had not had any case of post operative hemorrhage, which needs additional haemostatic operations, nor critical complications. Of these cases, we had the 101 ulcerated limbs of 95 patients until the 2008. The ulcers had not cured after various therapies, and all the patients were introduced to our institution as the obstinate venous ulcers. The cure rate of these C6 is 92.1% (93/101), and this result would be good enough for us.
The procedures of SEPS have been becoming easier than that of the beginning in 1998, mainly due to the changes of medical installments such as EndoTIP® and UCS (ultrasonic coagulation system).
Hereafter, it is better for SEPS to be introduced the most up-to-date procedures by the members of the Society of Endoscopic Therapy for Vascular Disease. And also it is necessary for estimate the availability of SEPS for C6 through the institutions, which are authorized as the national advanced medical system. This progress will be useful for the spread of SEPS.
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