‘Pin-Stripping’: A Novel Method of Atraumatic Stripping

1993 ◽  
Vol 8 (4) ◽  
pp. 171-173 ◽  
Author(s):  
A. Oesch
Keyword(s):  
Postoperative Complication ◽  
Saphenous Vein ◽  
Local Anaesthesia ◽  
Preliminary Report ◽  
Operation Time ◽  
Long Saphenous Vein ◽  
Short Saphenous Vein ◽  
Novel Method ◽  
Stab Incision ◽  
A New Technique

Objective: To assess the efficacy of a new technique for stripping segments of the short saphenous vein (SSV) or long saphenous vein (LSV). Design: Preliminary report on 83 cases. Patients: Seventy-five patients with incompetence of the SSV or LSV. Interventions: Forty-two partial Strippings and one complete stripping of the SSV; 40 Strippings of segments of the LSV. Results: The method described (‘Pin-stripping’) permits stripping without visualization of the distal end of the vein. Removal of the vein is possible through a stab incision and is feasible under local anaesthesia. Operation time is reduced and no postoperative complication was seen. Conclusions: Compared with conventional Strippings, ‘Pin-stripping’ offers several advantages in removing segments of the LSV or SSV.

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

1999 ◽  
Vol 14 (4) ◽  
pp. 158-161
Author(s):  
A. Shamiyeh ◽  
P. Schrenk ◽  
R. Rieger ◽  
W. Wayand
Keyword(s):  
Saphenous Vein ◽  
Clinical Stage ◽  
Technical Problem ◽  
Operation Time ◽  
New Technique ◽  
Invasive Technique ◽  
Surgical Department ◽  
Long Saphenous Vein ◽  
Postoperative Haematoma ◽  
A New Technique

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.

Recurrent varicose veins assessed by colour-coded duplex scanning: own experience

Phlebologie ◽  
2000 ◽  
Vol 29 (03) ◽  
pp. 58-61 ◽  
Author(s):  
G. Madycki ◽  
P. Dabek ◽  
A. Gabrusiewicz ◽  
W. Staszkiewicz
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Preoperative Assessment ◽  
Duplex Scanning ◽  
Group Iii ◽  
Recurrent Varicose Veins ◽  
Long Saphenous Vein ◽  
Group I ◽  
Short Saphenous Vein ◽  
Deep Vein

SummaryAim: Authors performed a retrospective analysis of causes of recurrent varicose veins following surgery. Methods: They evaluated 89 patients (65 women and 24 men, mean age 49.7 years). All patients previously underwent same surgical procedures (long saphenous vein stripping with/without local multiple avulsions). For the purpose of the study, colour/duplex examinations were applied (Siemens Sonoline Elegra unit). Results: Depending on the type and area of recurrent varicose veins, patients were classified into 4 groups. Group I – 22 patients (persistence of varicose tributaries of LSV in thigh or thigh perforator). Group II – 27 patients (recurrence along the LSV in the calf). Group III – 26 patients (recurrence due to left incompetent short saphenous vein). Group IV – 14 patients (isolated incompetent perforators). Authors conclude, that colour-coded duplex scanning is currently a method of choice in the diagnosis of recurrent varicose veins. High incidence of recurrence due to short saphenous vein incompetence should draw particular attention to this vein in the preoperative assessment of venous system. Recurrence of varicose veins at thigh level is not caused by deep vein insufficiency, but is related to inadequate vein surgery or might be linked to the problem of neovascularisation in this area.

Haemodynamic Correction of Varicose Veins (CHIVA): An Effective Treatment?

1996 ◽  
Vol 11 (3) ◽  
pp. 98-101 ◽  
Author(s):  
P. Zamboni ◽  
C.V. Feo ◽  
M. G. Marcellino ◽  
G. Vasquez ◽  
C. Mari
Keyword(s):  
Saphenous Vein ◽  
Continuous Wave ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
Group A ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein ◽  
Group B

Objective: Evaluation of the feasibility and utility of haemodynamic correction of primary varicose veins (French acronym: CHIVA). Design: Prospective, single patient group study. Setting: Department of Surgery, University of Ferrara, Italy (teaching hospital). Patients: Fifty-five patients with primary varicose veins and a normal deep venous system (ultrasonographic criteria) were studied. Interventions: Fifty-five haemodynamic corrections by the CHIVA method described by Franceschi were undertaken. Seven patients were treated for short saphenous vein varices (group A) while 48 patients were treated for long saphenous vein varices (group B). Main outcome measures: Clinical: presence of varices and reduction in symptoms. Duplex and continuous-wave Doppler detection of re-entry through the perforators and identification of recurrences or new sites of reflux. Postoperative ambulatory venous pressure and refilling time measurements. Patients were studied for 3 years following surgery. Results: In group A, 57% short saphenous vein occlusions with no re-entry through the gastrocnemius and soleal veins were recorded. In group B the long saphenous vein thrombosis rate was 10%. In this group 15% of the patients showed persistence of reflux instead of re-entry at the perforators. Early recurrences were also observed. Overall CHIVA gave excellent results in 78% of the patients. Statistically significant ambulatory venous pressure and refilling time changes were recorded ( p<0.001). Conclusions: CHIVA treatment is inadvisable for short saphenous vein varices. Long saphenous vein postoperative thrombosis is related to development of recurrences

scholarly journals Primary varicose veins: Frequency, clinical significance and surgical treatment

2004 ◽  
Vol 132 (11-12) ◽  
pp. 398-403
Author(s):  
Dragan Vasic ◽  
Lazar Davidovic ◽  
Zivan Maksimovic ◽  
Aleksandra Crni ◽  
Miroslav Markovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Saphenous Vein ◽  
Varicose Veins ◽  
World Health ◽  
Superficial Thrombophlebitis ◽  
Perforating Veins ◽  
Long Saphenous Vein ◽  
Significant Difference ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein

INTRODUCTION According to the definition of the World Health Organization, varicose veins represent abnormally enlarged superficial veins having baggy or cylindrical shape. The most frequent cause of primary varicose veins is the insufficiency of long saphenous vein (LSV), but especially the basin of its connection with femoral vein and perforating veins. OBJECTIVE The objectives of these investigations were: the determination of insufficiency incidence of SSV in cases of LSV insufficiency; the establishment of association of insufficiency of perforating veins of the basin of LSV and SSV; the study of the results of surgical treatment of insufficiency and varicosity of both short and long saphenous veins. METHODS In this study, 100 patients (66 women and 34 men), average age 52.1 years, with clinical symptoms showing the insufficiency and varicosity of long saphenous vein with no change of deep vein system were examined. Ultrasonographic examinations were made using Color Doppler probes - 7.5 and 3.75 MHz (Toshiba Corevison SSA 350 A); the development of incompetence of long saphenous vein (LSV) and short saphenous vein (SSV) at the level of the junction as well as other incompetent valves were examined. The reflux was defined as a retrograde flow of the duration longer than 0.5 seconds. RESULTS The insufficiency of short saphenous vein was determined by ultrasonographic examination in 34%, while the insufficiency of perforating veins in 80% of patients. 40% of patients were operated (33.3% of females, and 52.9% of males). The most frequent indications for surgical treatment of superficial veins insufficiency were: strong varicosities, clear symptoms and signs, superficial thrombophlebitis and conditions after superficial thrombophlebitis. Surgical treatment was applied in 16% of patients due to recurrence in the basin of long saphenous vein, and in 6% of cases because of the recurrence in the basin of short saphenous vein. Data analysis failed to discover any statistically significant difference between the age of patients and varicosities in the basin of long saphenous vein as well as in the basin of short saphenous vein (51.98?9.97 years; 54.50?31.82 years; t=0.36; p>0.05), or any significant difference of BMI value, with regard to the obesity of patients and varicosities in the basin of long saphenous vein as well as in the basin of short saphenous vein (28.02?4.61 kg/m2; 24.50?6.36 kg/m2; t=0.50; p>0.05). No statistically significant correlation was found between Color Duplex findings of insufficiency of both long saphenous vein and short saphenous vein (p=-0.21 ; p>0.05), nor any significant correlation of Color Duplex findings of perforating veins insufficiency in the basin of long saphenous vein and short saphenous vein (p=-0.115; p>0.05). CONCLUSION The incidence of insufficiency is significant: approximately every third patient has short saphenous vein insufficiency, while three third of patients have perforating veins insufficiency. Color Duplex limb's veins ultrasonography is highly reliable method for the examination and study of superficial veins diseases, which is very important for preoperative decision-making and selection of surgical technique as well as for postoperative follow-up.

The morphology of the varicose short saphenous system

2006 ◽  
Vol 21 (2) ◽  
pp. 55-59 ◽  
Author(s):  
L A Fowkes ◽  
S G Darke
Keyword(s):  
Saphenous Vein ◽  
Continuous Wave ◽  
Duplex Ultrasound ◽  
Entire System ◽  
Recurrence Rates ◽  
Female Ratio ◽  
Long Saphenous Vein ◽  
Continuous Wave Doppler ◽  
Short Saphenous Vein ◽  
Male To Female

Objective: Surgery for the varicose short saphenous vein (SSV) remains unsatisfactory. Specific problems include locating the saphenopopliteal junction (SPJ) and whether the trunk should be stripped. Recurrence rates are high. The objective was to review the morphology of varicose SSV and to address these aspects. Methods: Retrospective study of consecutive patients scheduled for SSV surgery based on initial continuous wave Doppler assessment. Detailed analysis of preoperative duplex ultrasound examinations with quantified reflux. Results: A total of 56 limbs (unilateral) were studied, male to female ratio was 18:38 and mean age was 51 years. SPJ: severe reflux in 47, mean diameter 8.1 mm (all above the skin crease [mean 2.7 cm]). Reflux was 'focal', being confined to the peri-junctional area with normal sized and competent distal short saphenous trunks in 29. In the remainder, incompetence was 'complete' with dilatation and reflux of the entire system. In only one limb did varicosities arise distally from a proximally competent system. Long saphenous vein ( LSV): coexistent reflux in 17, with communications with the SSV in 11. Deep reflux: at least one segment of deep reflux was found in 24 limbs. In this small study, no significant association with other morphology was found apart from 'complete' SSV reflux. Conclusion: The SPJ is usually severely incompetent, enlarged and sited above the skin crease. The morphology of the varicose SSV exhibits important differences from the LSV. In over half, incompetence is 'focal', confined to the peri-junctional vein and the distal trunk is competent suggesting a case for selective trunk stripping. Varicosities arising from a distally incompetent short saphenous trunk are uncommon.

Value of the Trendelenburg tourniquet test in the assessment of primary varicose veins

2004 ◽  
Vol 19 (2) ◽  
pp. 77-80 ◽  
Author(s):  
W H Hoffmann ◽  
I M Toonder ◽  
C H A Wittens
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Scanning ◽  
Observer Variability ◽  
Duplex Scan ◽  
Long Saphenous Vein ◽  
Inter Observer Variability ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein ◽  
Male Patients

Objective: Trendelenburg tourniquet tests should determine long saphenous vein (LSV), short saphenous vein (SSV) or perforating vein incompetence. This study analyses the inter-observer variability of the Trendelenburg test and the results are compared with duplex scanning - the standard for venous incompetence analysis. Methods: A total of 54 legs of 43 patients with varicose veins were investigated (36 female and seven male patients; mean age 47 years [range: 17-75]). All legs were evaluated for valvular incompetence by Trendelenburg tourniquet tests performed by three different investigators. A duplex scan was also performed in all legs. The inter-observer variability of the tourniquet test was expressed in Kappa (κ <0.5 indicated poor agreement). The sensitivity and specificity of the tourniquet tests are determined using the duplex scan as standard. Results: The inter-observer variability of the Trendelenburg test in detecting valvular incompetence of the LSV, SSV, perforating veins in the upper leg (PVU) and lower leg (PVL), expressed in Kappa, were: 0.39, 0.42, 0.14 and 0.49, respectively. The sensitivity of the tourniquet test in detecting valvular incompetence of the LSV, SSV, PVU and PVL, in relation to duplex scanning was: 50, 35, 52 and 35% respectively, and the specificity was 59, 72, 46 and 80%, respectively. Conclusions: The evaluation of patients with varicose veins with the Trendelenburg tourniquet test is unreliable and therefore obsolete. In order to manage patients with varicose veins properly duplex investigation is mandatory.

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

2011 ◽  
pp. 114-118
Author(s):  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Van Nghia Tran
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Central Hospital ◽  
Surgical Department ◽  
A New Technique ◽  
Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

Sign in / Sign up

Export Citation Format

Share Document