Subfascial Endoscopic Perforator Surgery Using Screw-Type Ports Is a Very Useful Component of a Comprehensive Treatment Program for Chronic Venous Insufficiency

Abstract

Background: Subfascial endoscopic perforator surgery (SEPS) with a two-port system utilizing screw-type ports, CO 2 insufflation and an ultrasonic coagulation system, is a useful procedure that does not require burdensome apparatus and techniques. SEPS was accepted as a national advanced medical system by the Japanese

Surgical methods and clinical results of subfascial endoscopic perforator surgery in Japan

“…Most clinical reports of SEPS were those of cases performed in the 20th century. Recent clinical reports were limited to the Netherlands, 10 Sweden, 11 India, 12 China, 13 Italy, 14 and Japan, 4,5 although endoscopic surgery has progressed remarkably in the 21st century. Favorable results of SEPS have been documented in reports from North America 2,15,16 and Europe.…”

“…Most SEPS procedures were performed by the twoport procedure using screw-type ports, EndoTIPs Õ , introduced by Haruta and Shinhara 4 Kusagawa et al 5 (Haruta's method, Figure 1). Briefly, a 6-mm skin incision was made in the healthy upper medial part of the Figure 1.…”

“…Most SEPS procedures were performed by the two-port procedure using screw-type ports, EndoTIPs®, introduced by Haruta and Shinhara 4 Kusagawa et al. 5 (Haruta's method, Figure 1). Briefly, a 6-mm skin incision was made in the healthy upper medial part of the lower leg, from where the first port was inserted into the subfascial space of the superficial posterior compartment by twisting off subcutaneous tissue and fascia, under the guidance of a 5-mm endoscope inserted through the port.…”

Recent Progress of Varicose Vein Treatment Especially about Endovascular Heat Ablation, SEPS and Foam Sclerotherapy

“…This led to the development of SEPS, in which IPV is resected without surgical invasion to the skin lesion. 18 – 20 ) Detailed description of the operative method will be omitted and supplemented by an illustration ( Fig. 3 ).…”

Subfascial endoscopic perforator surgery for posterolateral perforators performed in the prone position

“…In Japan, the two-port system utilizing screw-type ports (EndoTIP R , Karl Storz, Tuttlingen, Germany) was introduced by Haruta at the beginning of the 21st century, which made the performance of SEPS simpler and easier. 4,5 SEPS was accepted as a national advanced medical system by the Japanese Ministry of Health, Labor and Welfare in May 2009. SEPS is usually performed for the posteromedial perforators in the supine position.…”