Evaluation of Saphenous Nerve İnjuries in Total Saphenous Vein Stripping Without The Use of an Olive Material

Ali Vefa Özcan; Gökhan Önem; İbrahim Gökşin; Ahmet Baltalarlı; Orçun Ünal; Mustafa Saçar

Ali Vefa Özcan¹, Gökhan Önem¹, İbrahim Gökşin¹, Ahmet Baltalarlı¹, Orçun Ünal², Mustafa Saçar¹

¹Pamukkale Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, Denizli
²Osmangazi Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, Eskişehir

Background: Saphenous nerve injury is an undesirable complication during total stripping of the long saphenous vein. The procedure is associated with a high complication rate when stripping is performed with the use of an olive material. In this study, we investigated the complication rate of stripping operations without the use of an olive material.

Methods: Total saphenous vein stripping was performed in 30 extremities of 24 patients (15 males, 9 females; mean age 37 years; range 27 to 47 years). Stripping was performed from distal to proximal following high ligation and without the use of an olive material. Preoperatively, all the patients were examined by Doppler ultrasonography. During stripping, the saphenous vein was fastened to the wire two times at the distal region. In three extremities, splitting of the saphenous vein occurred and stripping was accomplished after reexploration of the vein below the knee level. All the patients were discharged 24 to 48 hours after the operation. Elastic bandages were used in the early period followed by routine use of compression stockings. Saphenous nerve deficits were evaluated with simple neurologic tests (sense, light touch, and vibration) at the end of the second postoperative month.

Results: Immediate observations at the end of the procedure showed that the stripped saphenous veins were free of any nerve tissue. Inadvertent splitting of the saphenous vein occurred in three extremities (10%). Simple neurologic tests performed at the end of two months revealed saphenous nerve deficit in only one extremity (3.3%). No complications such as recurrent varicose veins, hematoma, injury to the femoral artery, deep venous thrombosis, or pulmonary embolism were encountered.

Conclusion: Our data suggest that stripping of the saphenous vein without using an olive material is a safe procedure and results in a low rate of saphenous nerve injuries.

Keywords : Leg/innervation; peripheral nerves/injuries; saphenous vein/surgery; varicose veins/surgery; vascular surgical procedures/ instrumentation

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