Use of ultrasonic scalpel in subfascial endoscopic perforator vein surgery: a novel approach.

摘要

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. MATERIALS AND 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. CONCLUSION: 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.