MICROSURGERY FOR VARICOSE VEINS USING VARADY HOOK TECHNIQUE.

The classical high ligation and saphenous vein stripping requires hospitalization.Generalanaesthesia, long convalescence, loss of income, unacceptable scarring and possible permanent nerve injury. This report describes the technique of invaginated axial stripping in conjunction with tributary stab avulsion (Varadyhook) phlebectomy. Using femoral block anaesthesia with supplemented local infiltration or spinal anesthesia. the varicose tributaries are avulsed, through multiple stab incisions only 1.5-3 mm long, with specially designed hooks. This is performed in an ambulatory (office) setting, making varicose vein surgery a minimally invasive procedure. One hundred and sixty eight patients with 203 involved limbs were operated on during a two years period. Postoperative pain and complications were minimal. All patients immediately resumed normal daily activities. Cosmoses were excellent. There have been no recurrences in up to 2 years follow up. This procedure adheres to strict hemodynamic principles. Elimination of hospitalization, reduced postoperative morbidity, immediate ambulation, minimal nerve damage, excellent cosmoses and finally, obvious cost efficiency should make this form of varicose vein surgery appealing to surgeons and patients alike by making the future surgical care for varicose veins available today.