Fischer R
Chirurgische Praxis, St. Gallen.
Chirurg. 1994 Aug;65(8):736-8.
Invaginative stripping helps to reduce invasivity in varicose vein surgery. It therefore meets increasing interest. With this procedure however the saphenous vein sometimes tears off. This can be prevented in part of these cases by cutting the branches of the saphenous vein during stripping by means of the "sikkle" (Fig. 2). If it does not work then the remaining parts of the saphenous vein must be stripped in the conventional manner with a stripper head. However how can the stripper be introduced again into the stripper canal? One end of the tie which is used to knot the saphenous vein to the stripper is left long. In this way the long end of the tie remains in the stripper canal after invaginative stripping. This tie then can be used to pull another stripper into the stripper canal. In order to prevent the tip of the stripper to be caught in the subcutaneous tissue a special tip is used which we call "dolphin" (Fig. 5). It is a fish-shaped gadget with a mouth or a hook on one side for the tie and a thread at the other side for the thread of the stripper. Another possibility is to pull a second stripper after the first one by means of the "torpedo" (Fig. 3) whenever invaginative stripping is intended. The second stripper then can be used for conventional stripping if necessary.
内翻剥脱术有助于降低静脉曲张手术的侵袭性。因此，它越来越受到关注。然而，在这个手术过程中，大隐静脉有时会撕裂。在部分此类病例中，通过在剥脱过程中使用“镰刀”切断大隐静脉的分支（图2），可以部分预防这种情况。如果不起作用，那么大隐静脉的剩余部分必须用剥脱器头以传统方式进行剥脱。然而，如何将剥脱器再次插入剥脱器通道呢？用于将大隐静脉与剥脱器打结的线的一端留得较长。这样，在内翻剥脱术后，线的长端仍留在剥脱器通道中。然后，这根线可用于将另一个剥脱器拉入剥脱器通道。为了防止剥脱器尖端卡在皮下组织中，使用一种特殊的尖端，我们称之为“海豚”（图5）。它是一种鱼形装置，一侧有用于线的口或钩，另一侧有用于剥脱器线的线。另一种可能性是，每当打算进行内翻剥脱时，通过“鱼雷”（图3）在第一个剥脱器之后拉入第二个剥脱器。如果有必要，第二个剥脱器随后可用于传统剥脱。
