Modern Surgery Of Superficial Veins

Modern surgery of varicose veins started in 1806, when Tommaso Rima proposed a hemodynamic treatment with ligation of the upper GSV. This operation was reproposed in 1890 by Friedrich Trendelenburg: ". . . the saphenous reflux must be the first step in control distal varicosities . . ." It consisted of a double ligation of the great saphenous just

FIGURE 1.14 Sapenous interruption and its incannulation with the instrument called pagoda.

inferior to the saphenofemoral junction, thanks to a 3 cm incision. He boasted that he could do ". . . the operation so fast that no anaesthesia was required . . ." Trendelenburg made it clear that this technique had to be applied only to those limbs in which the compression tests, described by Brodie in 1846, revealed the incompetency of the saphenofemoral valve. In 1896, Moore of Melbourne refined the Trendelenburg operation, with the skin incision performed parallel and close to the inguinal fold, almost exactly as it is today. In the same year, Thelwall Thomas emphasized the importance of ligation and division of all branches at the saphenofemoral junction.

0 0

Post a comment