[Subfascial endoscopic supplementary surgery of perforating veins. Experiences with the first 100 procedures]

Leg ulcers following varicose veins and incompetent perforators have been treated by supplementary surgery of the perforators, originally by open operation, from the early eighties by endoscopic techniques.

The endoscopic operation is carried out through a short incision of the skin and fascia well above the skin changes, and consists of subfascial electro-cauterization and cutting of the incompetent perforators.

100 consecutive procedures were performed 1995-1999. Totally, the frequency of complications was 28%, mostly minor and self-limiting: Haematoma/haemorrhage 6%, infection 9%, deep vein thrombosis 1%, sural and saphenous nerve affection 9% and others 3%. With a median follow-up of 10 months, 94% of the patients were satisfied with the treatment, 5% experienced unchanged symptoms, 1% became worse. In 30 ulcer-cases, 80% were without recurrency after a median follow-up of 16 months, the rest having recurrent, but smaller ulcers.

The present results are similar to the experience reported by others. It is suggested that the technique may be developed in centers for advanced varicose vein surgery.