Fischer R
Chirurgie FMH, St. Gallen.
Vasa. 1993;22(4):316-9.
Invaginative Stripping reduces invasivity in varicose veins surgery. Therefore this technique meets increasing popularity. With invaginative stripping however the saphenous vein sometimes tears off. This can be prevented in part of the cases by cutting the branches of the saphenous vein during stripping with the "sickle" (Fig. 1). If this does not work then the remaining parts of the saphenous vein must be stripped in the conventional manner with a stripper head. But: 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 ordinary tip of the stripper to be caught in the subcutaneous tissue a special tip is used which we call "dolphin" (Fig. 4). 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 so that the second stripper can be screwed to it. Another possibility is to pull a second stripper after the first one by means of the "torpedo" (Fig. 2) whenever invaginative stripping is intended. The second stripper then can be used for conventional stripping if necessary.
内翻剥脱术可降低静脉曲张手术的侵袭性。因此，这项技术越来越受欢迎。然而，在内翻剥脱术中，大隐静脉有时会撕裂。在部分病例中，可通过在剥脱过程中用“镰刀”切断大隐静脉分支来预防这种情况（图1）。如果这不起作用，那么必须用剥脱器头以传统方式剥脱大隐静脉的剩余部分。但是：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长。这样，在内翻剥脱术后，线的长端会留在剥脱器通道内。然后可以用这条线将另一个剥脱器拉入剥脱器通道。为了防止剥脱器的普通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4）。它是一个鱼形装置，一侧有一个口或钩子用于系线，另一侧有一根线，以便第二个剥脱器可以拧到上面。另一种可能性是，每当打算进行内翻剥脱术时，借助“鱼雷”（图2）在第一个剥脱器之后拉入第二个剥脱器。如有必要，第二个剥脱器可用于传统剥脱术。
