SEPS is used for
. SEPS-Subfascial Endoscopic Perforator Ligation Surgery,it us recommended in chronic venous insufficiency. procedure: A special telescope is introduced deep to deep fascia through a single small veical incision at proximal leg selecting healthy skin.potential space between muscle and deep fascia with loose areolar tissue is easy to detect using endscope.Technique is done under torniquet 300 mm hg pressure.Endoscope is advanced down along the medial border of tibia.Perforators travelling in subfascial plane are identified and fulgurated using bipolar cauery or clips can be applied into the perforators.It is recommended in chronic venous insufficiency.But its limitation is difficuilty in getting "lift off" skin in cases with severe lipodermatosclerosis to identify the perforators. Refer page no 237 of SRB's manual of surgery 5 th edition.
Aery
Veins
Lymphatics
Lymphnodes
Vascular surgery