Invagination stripping of the long and short saphenous vein using the PIN stripper.

The technique of invagination stripping (IS) of the long saphenous vein (LSV) and short saphenous vein (SSV) using the PIN stripper (PS) is described. One hundred consecutive legs with long saphenous incompetence have been treated with IS of the LSV from the groin to just below the knee using the PS. In 28 of these legs associated short saphenous incompetence was treated with IS of the SSV from the popliteal fossa to just below half-way in the calf. It was found that technically the PS is easy to use. It passes from the groin to just below the knee in the LSV without difficulty. The blunt, slightly bent tip manoeuvres past tributaries and valves with ease. Similarly, the PS passes easily down the SSV to a point just past half-way down the calf. The exit of the stripper tip is much easier than with conventional strippers; there is less tissue trauma and a smaller scar. Inversion stripping is associated with much less tissue trauma, bruising and postoperative pain, and earlier mobilization. The technique appears to have eliminated trauma to the saphenous and sural nerves. This technique will facilitate the use of "day only surgery' for varicose veins and can be performed under femoral nerve block and local anaesthesia.