Saphenous vein stripping surgical technique and frequency of saphenous nerve injury

Objectives

Saphenous nerve injury is the most common complication after surgical treatment of varicose veins. The aim of this study was to establish its frequency at great saphenous vein long stripping when four methods of surgery were applied.

Methods

Eighty patients were divided into four groups depending on different stripping methods. Sensory transmission in saphenous nerve and sensory perception of shank were examined before surgery and two weeks, three and six months afterwards with clinical neurophysiology methods.

Results

In 36% of patients, surgeries caused the injury of saphenous nerve mainly by proximal stripping without invagination (65%, group I). Transmission disturbances ceased completely after three months in patients undergoing distal stripping with invagination (group IV), while in group I they persisted for six months in 35%. Group IV patients were the least injured and group I the most.

Conclusion

Neurophysiological findings may suggest that distal stripping with vein invagination gives the best saphenous nerve sparing.

Invagination stripping with ultrasound-guided perivenous tumescence: an original method of great saphenous vein stripping

BACKGROUND

Although minimally invasive treatment of the great saphenous vein (GSV) is now preferred over stripping, in some cases, stripping is still necessary. However, stripping, as an invasive method of treatment, promotes significant bleeding and trauma to the saphenous vein track.

OBJECTIVE

To describe an original method of GSV stripping, reducing bleeding during procedure.

METHODS AND MATERIALS

Seventeen patients underwent stripping of 29 GSVs using tumescent infusion in the saphenous compartment guided by ultrasound, similar to the tumescent anesthesia used in laser ablation during treatment of saphenous vein insufficiency.

RESULTS

Less bleeding and shorter recovery time was observed than in conventional GSV stripping.

CONCLUSION

GSV stripping using tumescent ultrasound-guided technique promotes less bleeding than conventional stripping and should be always performed when GSV stripping is considered. The authors have indicated no significant interest with commercial supporters.