Endoscopic perforator vein surgery

This is a technical name for a procedure which is only performed in severe cases of varicose veins. This means cases where leg ulcers have developed as a result of damaged veins.


This surgery uses endoscopy: a procedure which uses a camera mounted tube to view inside the body, e.g. the veins.

An endoscope is a long, flexible tube which has a video camera and a light source attached to one end. This tube can be inserted into the body through the mouth or via the anus. It can also be inserted through a small incision in the skin.

The video camera enables images of the body to be transmitted to a large video screen which are viewed by the surgeon. It also acts as a guide during the procedure in that he/she is directed towards the area to be treated.

In this situation, the endoscope is inserted into the damaged veins by means of an incision in the skin.

The endoscopic perforator vein procedure

Before surgery, you will undergo a duplex scan of the veins in your legs to determine the extent of the problem.

The surgeon will drain off blood from the lower leg to enable him/her to access the area. An incision is made in the lower half of the leg before inserting the endoscope. A special balloon, known as a "space making balloon" is also inserted which inflates the area to be treated.

This is usually accompanied by carbon dioxide gas which also helps to open up the area.

The surgeon now has greater access to the damaged veins. Using the endoscope as a guide, he/she ties off these veins. This is undertaken on the perforating veins – these are veins which act as a junction between the superficial veins and the deep veins. 

A dressing will be placed over the incisions. The surgeon will ask you to wear compression stockings after the operation and to wear them for a set period of time. This will help to speed up the healing process.

This procedure may be combined with other forms of treatment for maximum results.

This procedure is carried out under a general anaesthetic.

Advantage of endoscopic perforator vein surgery

This is a minimally invasive procedure which appeals to many people. This minimal approach means a quicker recovery period and being able to resume your normal daily routine.

Endoscopic procedures put less strain on the body than a large surgical incision which is one of the reasons why they are popular.

Plus there is less risk of developing an infection compared to an open form of surgery.

Another advantage is the fact that it is effective at treating varicose veins and leg ulcers.

Disadvantages of endoscopic perforator vein surgery

The disadvantages of this procedure are the same as for any type of surgery. They include a small risk of infection, pain and discomfort and bleeding.

Other risks include:

  • Haematoma (blood swelling under the skin)
  • Nerve damage
  • Deep vein thrombosis (DVT)

These risks as well as the benefits will be mentioned to you by the surgeon. He or she will explain these to you with the aim of enabling you to make an informed decision about surgery.

Guide to Varicose Veins

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