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August 11, 1956


JAMA. 1956;161(15):1459-1462. doi:10.1001/jama.1956.02970150027006

• Varicose veins that developed in 23 healthy, pregnant women between the ages of 22 and 42 years were treated surgically by a technique consisting of high ligation and complete stripping of the superficial system involved. The greater saphenous system was involved in all 23 cases; in addition, vulval varices were present in 8. Spinal anesthesia was used. Because the need for careful dissection and meticulous wound closure makes the operation time-consuming, two surgical teams worked simultaneously in those cases in which the procedure was bilateral. The preoperative marking of the skin, numerous details during operation, and postoperative care including early ambulation, all require close attention.

Because the operation relieved very troublesome symptoms, especially in cases of huge vulvar varices, all but one of the patients stated they were very glad they had the operation performed. It was found, however, that the removal of the major superficial venous systems did not prevent recurrence of varicosities during later pregnancies. The operation is therefore not advised except in women who do not contemplate having more children or who have vulvar varices so large as to indicate cesarean section.