PIN-Stripping
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PIN-Stripping of Oesch PIN-stripping was developed by Dr. Oesch. Standard vein stripping involves the use of a wire, or more commonly, a plastic cable, which is inserted at the sapheno-femoral junction and passed retrograde down the vein, or is inserted near the ankle or near or just below the knee and passed antegrade up the saphenous vein to the sapheno-femoral junction. There are two main disadvantages to this technique. One is the large sized "head" on the stripper, which may be 10-15 mm in size. When this is pulled through the tissue it creates considerable trauma. The second disadvantage is the fairly large incision required in the lower part of the leg needed either to insert it, or to extract, depending on which way the stripper is being passed. Dr. Oesch developed a slender rod which is normally passed from the level of the sapheno-femoral junction down the vein. It has a slight bend to the distal end, and can be easily found under the skin. I make a tiny incision here, and advance the stripper through the skin. The vein is then attached to the upper end of the stripper, and the vein is stripped by invagination (turning it inside out); thus there is no large stripping head being pulled through the tissues. By combining this with the tumescent anesthesia there is much less bruising and discomfort compared to the standard method of stripping. |
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