DEVELOPMENT OF THE SUBFASCIAL ENDOSCOPIC PERFORATOR VEIN SURGERY (SEPS) AND ITS INFLUENCE ON THE FINAL POSTOPERATIVE RESULTS

The aim of this study is to present results of treatment of 97 patient s (118 lower extremities) with chronic venous insufficiency (CVI) by u se of the new technique of subfascial endoscopic perforator vein surge ry (SEPS). Forty-seven extremities were assigned to class 4, 33 to cla ss 5, and 38 to class 6 of CVI. Eighty extremities (group A), were ope rated on earlier (1989-1993) by use of standard open endoscopic approa ch under direct vision, which is described further, whereas 38 extremi ties (group B) were operated on later (1993-1994) with use of modified endoscopic technique. The latter involved indirect vision by means of video technique, application of vascular clips, subfascial insufflati on of CO2, skin traction, and routine use of subfascial drainage. Clin ical outcome of the early postoperative and three monthly follow-ups w as judged on a published categorization of operative results. There we re 83.7% mild and moderate improvements in group A vs 89.4% in group B . The most significant late complication was dysesthesia in the distri bution of the saphenous nerve. This was observed in 6.2% of patients i n group A vs 2.6% in group B. We conclude that improvement of results of treatment was related to our growing experience and implementation of the modifications presented here.