Endoscopic Exploration of the Subfascial Space of the Lower Leg with Perforator Vein Interruption Using Laparoscopic Equipment: A Preliminary Report

Abstract

Objective: To describe a method of endoscopic exploration of the medial subfascial space of the lower leg using laparoscopic equipment and dividing incompetent perforating veins crossing this space with diathermy. Design: Prospective study in seven patients with significant perforating vein incompetence in the medial lower leg. Setting: Department of Surgery, Nepean Hospital, New South Wales, Australia. Intervention: Laparoscopic equipment is used to explore endoscopically the medial subfascial space of the lower leg. Incompetent perforating veins preoperatively marked by duplex examination are identified and divided by endoscopic diathermy. Main outcome measures: The endoscopic division close to their source from the deep veins of incompetent perforating veins of the medial compartment of the lower leg. Results: Endoscopic interruption of incompetent perforators in the medial compartments of seven legs achieved with minimal morbidity. Conclusions: Endoscopic diathermy interruption of incompetent perforators in the medial compartment of the lower leg using laparoscopic equipment is a rapid and accurate procedure with minimal morbidity, as shown in a small series of seven legs.