Vein Ligation and Stripping Health Article

Definition

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.

Purpose

The purpose of vein ligation and stripping is to reduce the number and size of varicose veins that cannot be treated or closed by other measures. The reasons for vascular surgery in general include:

• Improvement of the appearance of the legs. Large varicose veins are considered disfiguring by many people.
• Relief from pain, leg cramps, and fatigue that may be associated with varicose veins.
• Treatment of skin problems that may develop as complications of varicose veins. These include chronic eczema, skin ulceration, external bleeding, and abnormal pigmentation of the skin.
• Prevention of such disorders as thrombophlebitis and pulmonary blood clots.