Evaluation of subfascial endoscopic perforator vein surgery (SEPS) using harmonic scalpel in varicose veins: an observational study.

INTRODUCTION: Conventional modalities used to treat varicose veins with incompetent perforators and subsequent stasis ulceration have proved to be effective, however there are associated morbidities, such as postoperative pain, limited mobility, wound infection and dehiscence. Recent advances have been made in minimally invasive vein surgery techniques to decrease operative morbidity, number and size of incisions, recovery time, and operative time. METHODS: A prospective study of 21 patients of varicose veins with incompetent perforators undergoing subfascial endoscopic perforator vein surgery (SEPS) using harmonic scalpel was designed and various parameters were studied. RESULTS: All ulcers healed in 8 weeks with no recurrence in 11.9 months follow-up period. One case of wound infection and each saphenous nerve neuropraxia were the only postoperative complications noted. CONCLUSION: Use of ultrasonic scalpel in SEPS is technically feasible, causes less tissue damage as it generates a low thermal effect, and is associated with minimal morbidity.