Invaginated axial saphenectomy by a semirigid stripper: perforate-invaginate stripping

This study was designed to evaluate a recently introduced form of stripping of primary varicose veins by the technique of perforate-invaginate (PIN) stripping.

One hundred twelve consecutive limbs presenting with 91 long and 21 short saphenous varicosities displaying saphenofemoral or saphenopopliteal junctional escapes with varying length of greater or lesser saphenous (axial) reflux underwent operation in 1 year. All surgeries were performed in an office setting with the patient receiving locoregional anesthetic with use of the invaginated PIN stripping in conjunction with tributary hook-stab avulsion.

In the 112 procedures performed, there were no tract hematomas or dysesthesias caused by nerve damage. Postoperative morbidity was nonexistent, permitting all patients to resume normal daily occupational and sporting activities immediately.

PIN stripping is an excellent method of invagination stripping. There is a minimal likelihood of vein tearing. Compared with conventional ankle-to-groin (or popliteal fossa) stripping, PIN stripping is minimally invasive, does not cause damage to structures around the vein, does not require convalescence, eliminates the need for a lengthy distal second incision, can be performed in an office setting with the patient receiving locoregional anesthetic, and is most cost-efficient.