Abstract
Subfascial endoscopic perforator vein surgery (SEPS) was recently introduced as a minimally invasive method to ligate incompetent perforating veins in patients with severe chronic venous insufficiency of the lower extremities. Herein we describe a technique in which we used a 5-mm ultrasonic scalpel for the transection of perforating veins in 16 SEPS performed in 14 patients. The use of the ultrasonic scalpel allowed for the precise coagulation and transection of the perforator vein with hemostasis, while avoiding the use of metal clips. Our initial results showed that the technique was feasible with minimal morbidity. We recommend the use of the ultrasonic scalpel as an alternative tool to transect perforating veins in SEPS.
Similar content being viewed by others
References
Amaral JF (1993) laparoscopic application of an ultrasonically activated scalpel. Gastrointest Clin North Am 3: 381–392
Bergan JJ, Murray J, Gerason K (1996) Subfascial endoscopic perforator vein surgery: a preliminary report. Ann Vasc Surg 10: 211–219
Gloviczki P, Bergan JJ, Menawat SS, Hobson 2nd RW, Kistner RL, Lawrence PF, Lumsden A, O’Donnell TF, DePalma RG, Murray J, Pigott JP, Schanzer H, Ascer E, Kalman P, Calligaro KD, Ballard JL, Cambria RA, Rhee RY, Rubin BG, Ilstrap DM, Harmsen WS, Canton LG (1997) Safety, feasibility, and early efficacy of subfascial endoscopic perforator surgery: a preliminary report from the North American Registry. J Vasc Surg 25: 94–105
Hambley R, Hebda PA, Abell E, Cohen BA, Jegasothy BV (1988) Wound healing of skin incisions produced by ultrasonically vibrating knife, scalpel, electrocautery, and carbon dioxide laser. J Dermatol Surg Oncol 14: 1213–1217
Herline AJ, Fisk JM, Debelak JP, Shull Jr HJ, Chapman WC (1998) Surgical clips: a cause of late recurrent gallstones. Am Surg 64: 845–848
Linton R (1938) The communicating veins of the lower leg and the operative technique for their ligation. Ann Surg 107: 582–593
Pierik EG, van Urk H, Hop WC, Wittens CH (1997) Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: a randomized trial. J Vasc Surg 26: 1049–1054
Porter JM, Moneta GL (1995) International Consensus Committee on Chronic Venous Disease. Reporting standards in venous disease: an update. J Vasc Surg 21: 635–645
Sparks SR, Ballard JL, Bergan JJ, Killeen JD (1997) Early benefits of subfascial endoscopic perforator surgery (SEPS) in healing venous ulcers. Ann Vasc Surg 11: 367–373
Stuart WP, Adam DJ, Bradbury AW, Ruckley CV (1997) Subfascial endoscopic perforator surgery is associated with significantly less morbidity and shorter hospital stay than open operation (Linton’s procedure). Br J Surg 84: 1364–1365
Whiteley MS, Smith JJ, Galland RB (1998) Subfasical endoscopic perforator vein surgery (SEPS): current practice among British surgeons. Ann R Coll Surg Engl 80: 104–107
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lee, D.W.H., Chan, A.C.W., Lam, Y.H. et al. Subfascial endoscopic perforator vein surgery (SEPS) using the ultrasonic scalpel. Surg Endosc 15, 1491–1493 (2001). https://doi.org/10.1007/s004640000370
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s004640000370