Exposure

Feel for the groove between the medial malleolus and tibialis anterior, just above the medial malleolus. Make a 1-2 inch incision in the line of the saphenous vein direction using the 22-blade.

Use Mcindoe scissors to dissect and expose the vein. Insert the larger curved Mayo’s above the vein and create a tunnel travelling cephalad. The tunnel length should be at least the length of the scissor’s blades. Place mosquito forceps on any bleeding superficial veins.

Expose the entire length of the vein required.

Cannulate – Dissect out the most distal part of the vein using mosquito forceps. Clamp the distal end, make a partial cut on the vein and cannulate it with a Tibbs cannula. Ensure the syringe is dripping as it is engaged with the cannula. Apply a pulsating distending gentle pressure to fill the vein.

Dissect the branches out with mosquito forceps. Apply mosquitos on all branches. Apply ligatures and clips on the vein side, leaving the mosquitos in situ.

Once the vein is freed up, place a clean dry swab under the vein. Distend and apply ligaclips as necessary. Use 7-0 prolene for any avulsions or tears.

Disconnect on either end.