Abstract
Antegrade stripping of the above-knee segment of the long saphenous vein (LSV) is a standard part of varicose vein surgery for saphenofemoral incompetence. Our unit uses a pin stripper to achieve satisfactory disruption of the above knee portion of the LSV. We describe a technique to improve pain control following a LSV strip. The LSV is stripped in the standard manner using a pinstripper that is tied to the proximal LSV using a 0 Vicryl™ (Ethicon, Edinburgh EH11 4HE, UK) tie. It is essential that the trailing length of tie be of sufficient distance to allow retrograde insertion of a size 7 umbilical catheter. Following removal of the pin stripper and LSV through a distal incision, the Vicryl tie is used to attach a size 7 umbilical catheter. Traction on the Vicryl tie from above allows the catheter to be drawn into the leg where the LSV has been stripped. Following this, 15 ml of 0.25% Chirocaine (Celltech, Cambridge CB4 4WE, UK) can be instilled as the catheter is removed, thus ensuring the bed of the LSV is adequately anaesthetised. We find this technique to be both simple and effective.
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