Type of Surgery
Last updated: 02/17/2009
Vein ligation and stripping is a surgical approach to the treatment of varicose veins. It is also sometimes called phlebectomy. Ligation refers to the surgical tying off of a large vein in the leg called the greater saphenous vein, while stripping...
refers to the removal of this vein through incisions in the groin area or behind the knee. If some of the valves in the saphenous vein are healthy, the weak portion of the vein can be closed off by ligation. If the entire vein is weak, it is closed off and pulled downward and out through an incision made below it. Tying and removal of the greater saphenous vein is done to reduce the pressure of blood flowing backward through this large vein into the smaller veins that feed into it.
Phlebectomy is one of the oldest forms of treatment for varicose veins; the earliest description of it was written by Aulus Cornelius Celsus, a Roman historian of medicine, in A.D. 45. The first description of a phlebectomy hook comes from a textbook on surgery published in 1545. The modern technique of ambulatory (outpatient) phlebectomy was developed around 1956 by a Swiss dermatologist named Robert Muller. As of 2003, surgical ligation and stripping of the saphenous vein is performed less frequently because of the introduction of less invasive forms of treatment.
Vein ligation and stripping is a minor surgery. It is used to remove a damaged vein and prevent complications of vein damage. If several valves in a vein and the vein itself are heavily damaged, the vein (or the diseased part of the vein) is removed (stripped). An incision is made below the vein, a flexible instrument is threaded up the vein to the first incision, and the vein is grasped and removed.
During this surgery, one or more incisions are made over the damaged veins, and the vein is tied off (ligated). If the ligation cuts off a faulty valve and the vein and valves below the faulty valve are healthy, the vein may be left in place to continue circulating blood through other veins that still have valves that work well.
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