Endoscopic removal of the long truncal vein

This entirely new vein surgery technique is derived from cardiovascular surgery, where the very careful removal of the long anterior superficial truncal vein (the great saphenous vein) serves in the application of a graft during bypass surgery.

Because the method is especially gentle and tends to result in an especially fast regeneration following the vein surgery, we have successfully included it in our repertoire and have acquired very good results with its use.

The treatment

• Through a small incision in the region of the inside of the thigh, barely above the knee, a special endoscope (tiny video camera) is introduced under the skin and used to separate the afflicted truncal vein fully and carefully from the surrounding connective tissues, in all directions. Thereby, all side branches of the vein are carefully closed by means of electric impulses and then severed.
• This is a very decisive advantage as opposed to even the most cautious of stripping procedures since the side branches are always torn off during this procedure can lead to (considerable) haemorrhaging in the thigh. After the vein has been freed, the entire vessel can be taken from the leg without any force (if necessary, a further small incision must be performed in the groin to carry this out).

Advantages of this vein surgery

• This vein surgery procedure (which is technically very intricate, but also extremely gentle) has the very great advantage of allowing a gentle release of the truncal vein from the area while simultaneously severing the side veins without any haemorrhaging.
• This haemorrhaging in the thigh - which inevitably occurs during all forms of stripping - compromises the patient's condition quite significantly after vein surgery and is the primary reason for requiring a compression therapy on the thigh, which demands that long compression stockings be worn, frequently for 6 to 12 weeks.
• Thanks to this extreme protection of the tissues, we recommend only three days of compression stockings and our patients are able to return to work and participate in sporting activities almost immediately.

This method must by no means be confused with the endoscopic surgery of the “perforans veins” (also known as endoscopic subfascial discission of perforans veins (ESDP) - a procedure which is today considered to be obsolete)! This vein surgery technique is only rarely employed and used by few physicians today, in special cases involving varicose ulcers, and continues to disappear further in favour of other techniques.

Because this treatment puts high demands on the technical equipment of the clinic and on the surgical/endoscopic experience of the surgeon, it is rarely applied other than in cardiovascular surgery.

Here, however, we see a wonderful addition to the other gentle methods practiced by us (like, for example, radiofrequency therapy, laser spider vein removal and the steam vein catheter sclerosis method).

Especially in patients where the radiofrequency catheter treatment cannot be undertaken for various reasons, endoscopic vein surgery offers an outstanding alternative to the otherwise mandatory conventional stripping.