title: Subfascial endoscopic perforator surgery for posterolateral perforators performed in the prone position.
abstract: OBJECTIVE
  Subfascial endoscopic perforator surgery (SEPS) is usually performed for posteromedial perforators in the supine position, but subfascial endoscopic perforator surgery for posterolateral perforators in the prone position has not been reported.
  
  
  METHODS
  A 51-year-old male suffered from a venous stasis ulcer around his lateral malleolus because of reflux in the small saphenous vein and incompetent perforating veins around the ulcer.
  
  
  RESULTS
  Stripping of the small saphenous vein and subfascial endoscopic perforator surgery utilizing screw-type ports was successfully conducted in the prone position.
  
  
  CONCLUSIONS
  The prone position enables interruption of the posterolateral perforators, because gravity-dependent flattening of the muscles enables creation of sufficient subfascial space.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Matsusaka Chuo General Hospital, Matsusaka, Mie, Japan h-kusagawa@mch.miekosei.or.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kusagawa
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Matsusaka Chuo General Hospital, Matsusaka, Mie, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Shomura
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Matsusaka Chuo General Hospital, Matsusaka, Mie, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Komada
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Matsusaka Chuo General Hospital, Matsusaka, Mie, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Katayama
authors.affiliation: Department of Vascular Surgery, Takano-bashi Central Hospital, Hiroshima, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Haruta
mesh_terms: D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D006112:Gravitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D010858:Pigmentation; D016684:Prone Position; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods*; D014689:Venous Insufficiency / Q000601:surgery
keywords: Subfascial endoscopic perforator surgery; chronic venous insufficiency; incompetent perforators; venous stasis; venous ulceration