Babcock stripping of v. saphena magna

Surgical crossectomy in case of crossen insufficiency.

3-4 cm long incision above the hiatus saphenus in the groin, blunt dissection of the entrance of the V. saphena magna with depiction of the venous star, the crosses and if possible all its lateral branches. Ligation of the V. saphena magna at its confluence with the V. femoralis, ligation of the lateral branches. Insertion of the Babcock probe (stripper) from proximal to below the distal point of insufficiency, incision of the skin over the end of the probe, exposure of the vein to below the probe, clamping off distally, cutting through the vein, fixation of the vein end by ligature to the probe; then stripping under traction of the vein from distal to proximal. Hemostasis by elevation during surgery and immediate postoperative compression therapy with short-stretch bandages, later compression stocking.

Post-operative: Low-dose heparinization with 2000-3000 anti-FXa units of low-molecular-weight heparin such as Nadroparin (once/day 0.2-0.3 ml Fraxiparin s.c.), alternatively: 7500 IU Heparin s.c. 3 times/day.

Mobilisation of the patient from the 1st postoperative day, 4-6 weeks compression therapy with elastic short-stretch bandages (e.g. Pütter Verband Fa. Hartmann).

1. Babcock WW (1907) A new operation of varicose veins of the leg. New York Medical J 86: 153-156
2. Breuninger H et al (2001) Cryostripping of the long saphenous vein with a percutaneously guided probe. Dermatol Surgery 27: 545-548
3. Elias SM et al (2004) Minimally invasive vein surgery. Mt Sinai J Med 71: 42-46
4. Pourhassan S et al (2001) [Recurrent varicose veins. Surgical procedure - results. Central Bl Chir 126: 522-525
5. Surgical procedures for varicose veins: axial stripping and stab avulsion (1992) Atlas of venous surgery. Saunders, Philadelphia, pp 61-77