Subfascial endoscopic perforator vein surgery using balloon dissector and saphenous vein surgery in chronic venous insufficiency.

Objectives: Subfascial endoscopic perforator vein surgery (SEPS) has recently been a popular alternative to classical surgical methods in the treatment of severe venous insufficiency of the lower extremity. Yet, there are not many reports concerning this less invasive operation, and many modified methods are applied. We would like to report the clinical results of our country's first SEPS operations performed by using balloon dissector.

Methods: The SEPS via two ports and using balloon dissector with saphenous vein stripping and phlebectomy in patients with severe venous insufficiency. Pneumatic tourniquet has never been applied.

Results: Twenty-eight operations were performed on 28 patients (13 female, 15 male). Active open ulcers were present in four legs, ulcer scars were present in two patients, skin changes were present in 12 legs and severe oedema was present in 10 legs. An improvement in all clinical findings and complaints was determined following the operations. A significant drop was determined in chronic venous insufficiency scores. No serious complication requiring rehospitalization of the patients was observed. All the patients were followed up for six months, and none presented again with any complaints.

Conclusion: SEPS using balloon dissector with saphenous vein surgery we performed is an effective, reliable and promising method.