Subfascial endoscopic perforator vein surgery (SEPS) modified technique: subaponeurotic approach without balloon.
Subfascial Endoscopic Perforator Vein Surgery (SEPS) is one of the best procedures and a minimally invasive option for treating chronic venous insufficiency. We explain our experience with SEPS, which has been turned into a subaponeurotic approach without balloon, and assess the possible advantages of this technique. The subaponeurotic space was entered using the Visiport Plus (Autusuture, Tyco Healthcare) video-assisted technique, which shows how the trocar enters through the subcutaneous tissue and superficial aponeurosis of the leg. A blunt retractor was inserted which, together with CO2 insufflation (20 mm Hg), enabled the veins to be dissected. Ligation was performed using tripolar sealing. In no case was a balloon used. There were no incidents such as haemorrhage or subcutaneous emphysema during the procedure. The patients (n = 206) remained in the hospital for less than 24 hours and suffered no post-surgical complications. Active ulcers were cured, with no relapses, in 100% of cases. This is a very effective method for treating advanced chronic insufficiency because it prevents local damage and the rate of post-surgical complications is low. Technically it has more advantages because the fact that it does not use a balloon means that it exerts less pressure on the tissues.
Blasco
Santiago Blanco
SB
Sant Joan University Hospital, Reus, Surgery Service, Tarragona, Spain.
Hernández González
Mercé
M
Sabench Pereferrer
Fátima
F
Diáz Lara
Carlos
C
Vilalta
Francisco Buils
FB
Rivas
Antonio Morandeira
AM
Del Castillo Déjardin
Daniel Del Castillo
Ddel C
D000328:Adult; D000368:Aged; D017546:Angioscopy / Q000379:methods*; D002908:Chronic Disease; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012501:Saphenous Vein / Q000601:surgery; D014647:Varicose Ulcer / Q000601:surgery*; D014689:Venous Insufficiency / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000379:methods*