[Endoscopic sub-fascial perforant vein dissection in the treatment concept of primary varicose veins].

Subfascial dividing of insufficient perforating veins is considered the most effective therapeutic principle in the treatment of primary varicosis and postthrombotic changes or varicosis-related trophic disturbances of the skin. A new endoscopic technique allows these veins to be sectioned under direct vision, with little trauma. Between November, 1986 and August 1991, 74 patients underwent endoscopic sectioning of perforating veins in a total of 106 legs. In 100 legs, the procedure was combined with a conventional stripping operation. The perforating veins divided most frequently involved the Cockett group (223), the 24 cm perforating vein (86) and the Boyd group (83). In three legs (2.8%) showing trophic skin changes in the lower leg area impaired wound healing was seen postoperatively. Follow-up examination carried out 27 months after the procedure revealed insufficient perforating veins in two of the legs treated. New varices were seen in nine legs. In terms of staging of chronic venous insufficiency, either a more favourable stage or complete healing can be achieved in 90 of the cases.