Use of ultrasonic scalpel in subfascial endoscopic perforator vein surgery: a novel approach.
BACKGROUND
The aim of this study was to determine the feasibility of using the ultrasonic scalpel in subfascial endoscopic perforator vein surgery (SEPS) and study the results of ulcer healing and reversal of skin changes.


METHODS
From January 2003 to November 2005, we performed 47 SEPS in 42 patients under spinal anesthesia, using the two-port technique. All patients had chronic venous insufficiency ranging from class IV to VI.


RESULTS
Duration of surgery for SEPS averaged 30 minutes, with no postoperative mortality. One patient developed a wound infection at the port site, which was managed conservatively. None of the procedures required a conversion to open surgery. We have had no recurrence of venous ulcer, so far. Barring 1 patient, all patients returned to normal routine within 5 days of surgery. In more then 90% of patients, ulcer healing was achieved within 8 weeks of surgery.


CONCLUSIONS
Our study clearly shows that the ultrasonic scalpel is a very safe, reliable tool in SEPS, as there was very low morbidity regarding wound complications and other per- or postoperative complications, which can be there when one uses the metallic clips or electrocautery for SEPS.
Jain
Sudhir Kumar
SK
Department of Surgery, Maulana Azad Medical College, Delhi, India. sudhirkumar11@gmail.com
Gupta
Amit
A
Murti Kaza
Ram Chandra
RC
D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014464:Ultrasonic Therapy / Q000295:instrumentation*; D014647:Varicose Ulcer / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods; D014689:Venous Insufficiency / Q000601:surgery*; D014945:Wound Healing