356. Die endoskopische subfasciale Discision der Perforansvenen (ESDP)

Hauer, G.; Deiler, S.; Marb, H.; Wisser, I.; Reich, Harry

doi:10.1007/bf01274676

Cited by 11 publications

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“…This technique proved to be a practical method for accessing the subfascial space [11]. There are currently many reports relating to the SEPS operation and the salutary longterm results achieved with this procedure [3,9,13].…”

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confidence: 99%

Treatment of severe chronic venous insufficiency using the subfascial endoscopic perforator vein procedure

et al. 2004

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This study demonstrated the effectiveness of the SEPS procedure when incorporated into the overall treatment strategy for patients with chronic venous insufficiency. Minimal postoperative complications accompanied by ulcer healing and relief of lower extremity symptoms were achieved for all the patients, underscoring the important role of incompetent perforator veins in the formation of chronic venous insufficiency.

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Treatment of severe chronic venous insufficiency using the subfascial endoscopic perforator vein procedure

et al. 2004

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“…The introduction of endoscopic techniques for subcutaneous surgery of the lower extremities has led to significant advances in the treatment of patients with varicose veins [2] and in a reduction in wound morbidity after coronary artery bypass [8]. By insufflation of CO 2 into the subcutaneous plane, an expanded operative space is created, and viewing and manipulation are greatly improved [1].…”

Section: Discussionmentioning

confidence: 99%

A soft dual-port trocar for endoscopic subcutaneous surgery

et al. 2001

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“…Nach einigen Berichten u Èber eine direkte ¹Skopieª distaler Perforansvenen am medialen Unterschenkel im Subfaszialraum u Èber Rektoskope, Mediastinoskope oder a Èhnliche Instrumente war es Hauer, der Anfang der 80er Jahre systematisch ein geeignetes Instrumentarium zur ESDP entwickelte [13]. Dabei war einer der ersten Schritte die Konstruktion einer stabilen Optik zur videoendoskopischen Betrachtung (Operationsschema siehe Abbildung 1 b).…”

Section: Entwicklung Der Endoskopischen Dissektionunclassified

“…Dennoch dauerte es viele Jahre bis sich u Èber mehrere Zwischenstufen eine neue Operationstechnik etablierte, die u Èber eine Inzision fern der beschriebenen La Èsionen die gezielte Unterbrechung der pathologischen PV ermo Èglichte. Hauer begann Mitte der 80er Jahre mit der konsequenten Entwicklung der endoskopischen Technik, die von ihm und anderen Arbeitsgruppen schrittweise etabliert wurde [13].…”

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Die Entwicklung der Perforansvenenchirurgie vom offenen Verfahren nach Linton und Cockett zur endoskopischen Dissektion*

Lang¹

2001

Zentralbl Chir

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Interruption of incompetent perforator veins (PV) is regarded as one of the principles of therapy in cases of severe stages of chronic venous insufficiency. This paper is to demonstrate the development of PV surgery from the original procedure (termed the radical Linton's operation after its originator) to minimal invasive approaches as the subfascial endoscopic perforator vein surgery (SEPS). Subfascial or epifascial interruption is frequently complicated by poor postoperative wound healing (sometimes more than 50%) even in cases with smaller incisions as the former Linton's procedure. PV interruption by hooks and special knives has been in wide use, however, the procedure is not as precise as a direct subfascial approach. The blind subfascial perforator interruption and fasciotomy by Hach has been advocated in severe forms of chronic venous insufficiency. It was Hauer at the beginning of the eighties who introduced a video-controlled surgical approach using a scope with fiberoptic lighting and video camera. At this time, a variety of instruments and modified techniques exists, but the effect of SEPS on venous hemodynamics and clinical outcome is not totally proven due to an additional reflux or obstruction in the deep or saphenous veins and concurrent epifascial surgery. A lower rate of complications of the endoscopic procedures is described, however, there is still a rate of about 5% hematoma and about 7% delayed wound healing. SEPS is an important adjunct in severe cases of PV insufficiency with chronic venous ulcers and lipodermatosclerosis. SEPS will fail in circular crural ulceration where the lesion should be totally excised and covered with skin transplantation. Up to now there is no study to demonstrate the efficacy of SEPS in patients with primary saphenous vein incompetence without deep reflux.

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356. Die endoskopische subfasciale Discision der Perforansvenen (ESDP)

Cited by 11 publications

References 0 publications

Treatment of severe chronic venous insufficiency using the subfascial endoscopic perforator vein procedure

Treatment of severe chronic venous insufficiency using the subfascial endoscopic perforator vein procedure

A soft dual-port trocar for endoscopic subcutaneous surgery

Die Entwicklung der Perforansvenenchirurgie vom offenen Verfahren nach Linton und Cockett zur endoskopischen Dissektion*

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