Use of Ultrasonic Scalpel in Subfascial Endoscopic Perforator Vein Surgery: A Novel Approach

Abstract

Our study clearly shows that the ultrasonic scalpel is a very safe, reliable tool in SEPS, as there was very low morbidity regarding wound complications and other per- or postoperative complications, which can be there when one uses the metallic clips or electrocautery for SEPS.

Comparing ultrasound guided foam sclerotherapy with surgical treatment in patients of varicose veins

“…The M:F ratio found in our study is in sharp contrast to the ratio mentioned in most of the western literature, where more females were suffering from this disease. 8,11,12,18,21,26 However in the study conducted by Jain et al, 41 of the 42 patients were males; by Masuda et al 42 of the 68 patients were males. 12,13 Majority of our patients were young with a mean age of 35.32 years in both group.…”

“…19 Jain et al discharged their patients after a mean duration of 4.5 days, the reasons for keeping the patients for this much of time was not specified. 12 After the foam sclerotherapy, almost all the patients were discharged the same day after a short period of observation in most of the studies. 11,18,22,26 We are currently discharging the patients within 2 hour of the procedure.…”

Evaluation of stab avulsion versus subfascial endoscopic perforator surgery in the management of chronic venous insufficiency resulting from incompetent leg perforators in primary varicose veins

“…A similar finding was observed by Lee et al, in which they used ultrasonic harmonic. 2,12,13 The high incidence of wound infection in the open group is because of an incision in already compromised skin, which causes delayed wound healing and increases the chances of infection. In the present study, there was no redness, ecchymosis, and pain at the site of incisions in both groups, as reported in the literature.…”

“…SEPS can be performed by using an ultrasonic scalpel, 2,12,14,15 metal clips, 7 electrocautery. 7 The use of metal clips is timeconsuming and may act as a nidus for infection, and also there is a risk of a migration of the clips.…”

“…This instrument, which works in a smoke and blood-free space, is now widely used in a number of laparoscopic procedures. 16 SEPS can be performed by using routine endoscopic urology or gastrointestinal surgery instruments 2,7,12,14,17,18 or specialized instruments designed for SEPS, but these ports increase the cost of surgery. 12,15 In our study, we did not use any specially designed instruments, but we used routine laparoscopic instruments.…”