Surgical Stripping of Varicose Veins
The traditional technique for surgical stripping is ligation and stripping of the great saphenous vein (GSV), the long vein that extends from the anklebone along the inside of the leg and thigh and empties into the femoral vein in the groin. Ligation and stripping involves tying off the abnormal vein (ligation) and physically removing it (stripping).
Ligation and stripping are performed in a hospital setting or outpatient surgical center under local, spinal, or general anesthesia. The surgeon makes a small incision in the groin to expose the diseased GSV, which is tied off. The surgeon then makes a series of incisions along the leg from the thigh to a point just below the knee. Using a specialized stripping tool that is inserted and threaded through the incisions, the surgeon strips out the diseased vein.
A more recent variation on this technique is PIN (Perforate Invaginate) stripping. This technique involves inserting an instrument called a PIN stripper through a small incision in the leg. The stripper is advanced through the vein, its tip is sewn to the end of the vein, and the vein is pulled in on itself as it is stripped out of the leg. PIN stripping is performed in a hospital operating room or outpatient surgical center under general anesthesia or local anesthesia with IV sedation.
During stripping, branch veins attached to the GSV are broken, causing blood to leak into surrounding tissues. This causes the postoperative pain, soreness and bruising experienced by ligation and stripping patients. Other potential complications include numbness from damage to surrounding nerves, chronic leg swelling from damaged lymphatic tissue, incision scars and allergic reaction to anesthesia. Although the patient is usually able to return home the same day, recovery from vein stripping surgery typically takes up to four weeks, with patients sidelined for several days in the beginning.
Surgical vein stripping is far more invasive than the VenaCure EVLT™ procedure. Additionally, a study published in the Journal of Vascular Surgery in 1999 revealed that vein stripping surgery was 71% effective in eliminating varicose vein, compared to a success rate of up to 98% for the VenaCure EVLT™ procedure. Endovenous laser vein therapy also causes less bruising and numbness and leaves minimal to no scars as compared to surgical ligation and vein stripping.