By Mitchel P. Goldman, Mihael Georgiev, Stefano Ricci
The one textual content in particular dedicated to the topic, this moment variation serves as an entire and sensible consultant for office-based surgical procedure of varicose veins-providing a number of illustrations showcasing the anatomy of varicose veins, in addition to step by step assurance of the ambulatory phlebectomy strategy.
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Additional info for Ambulatory Phlebectomy, Second Edition (Basic and Clinical Dermatology)
He clearly described multiple ligation of the varices and also, eight centuries before Mayo, the GSV stripping. Guy de Chauliac (1300– 1368) He was born in the Ge´vaudan region, he was Christian, he inspired to Albucasis. He recommended multiple serial incisions of varices, followed by cauterization or avulsion. These two great surgeons rediscovered the treatment described by Celsus, although ignoring it. Guy de Chauliac was a traveler. As an anecdote we remind the tremendous hate he was submitted to by the poet Petrarca (born in Arezzo in 1304), the first humanist of the renaissance.
Hooks are placed at a four finger distance each other, all along the vein; when cauterization has been completed, remedies are applied that are employed for burns (. . medicamentum, quo adusta sanatur). Excision instead is done as following. After skin division as in the former way, the wound edges xxxvi History of Ambulatory Phlebectomy are grasped with the hooks; then the scalpel is used to entirely isolate the vein from the surrounding parts taking care not to injure it. This done, blunt hooks are slipped under the vessel, while keeping them separated as told before.
Other times it can be so superficial as to resemble a CV. 5 The GSV lies into the interfascial space (saphenous compartment) enclosed between the leaves of the superficial fascia and the deep (aponeurotic) fascia. The entire length of the GSV is in the compartment. In over 40% of cases, in the upper thigh, lateral to the GSV, there is a second vein in the compartment called anterior ASV. 12 Ricci, Georgiev, and Goldman totally double (sometimes even triple) vessel, and in 52% a combination of single and double segments (9).