The so-called "crossectomy-stripping" technique, commonly known as stripping, involves tearing the saphenous vein as well as all the connecting veins between the varicose vein and the deep veins.
Developed more than a century ago, this technique was until recently the standard surgical procedure for the radical treatment of incompetent saphenous veins. She is now competing with endovenous techniques.
Crossectomy (removal of part of the saphenous vein) and stripping (removal of adjacent superficial veins) are performed by two small skin incisions. The large saphenous vein, located between the groin and the knee, and the small saphenous vein located between the knee and the ankle are treated. A hook (the "stripper") is introduced into the saphenous vein to hang on, the far end of the vein being extracted by turning over on itself.
The intervention is carried out under general anesthesia, rachianesthesia (sleep of the lower limbs) or local anesthesia by tumescence (infiltration of an anesthetic solution in the subcutaneous tissue).
Stripping only treats the saphenous vein, large or small. Other visible varices, unsightly on the thighs or legs, will benefit from complementary treatment either by phlebectomy (the picking of superficial veins) or by sclerotherapy.
Complications et side effects
Potential complications and side effects include: bruising and hematoma, groin scar infection, venous thrombosis (phlebitis), sensory disturbances resulting from neurological involvement, allergic manifestations, pain or tingling.
Monitoring and care
Given the potential complications mentioned above, a postoperative follow-up is required.
A period of convalescence, of the order of 2 to 3 weeks, is generally necessary. Even if it is possible to walk again the next day, a work stoppage may be recommended to limit the effort on the operated members. The wearing of stockings is mandatory for 2 to 4 weeks. Preventively, the rapid recovery of the walk is nevertheless recommended.
In the case of venous thrombosis, anticoagulants are prescribed and a compression by band and elastic stockings is put in place.
In the long term, a follow-up of the venous state is necessary because of the possibility of varicose recurrences. This requires complementary treatments either by sclerotherapy or by phlebectomy.
Given the invasiveness of the act, it is currently preferable to use endovenous ablation techniques. There are still some indications specific to stripping surgery, such as sinuous veins not accessible with thermal ablation treatment.
General overview of treatments
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