In most cases of varicosity of great saphenous vein

the tortuous veins appear mainly over the leg instead of the thigh

although the upmost valve of the vein is incompetent. Thus

a new operative procedure

high level circumferential constricting process of the upmost saphenous valvular segment

was designed.We stripped the tortuous veins over the leg only and left the veins over the thigh intact.Before stripping the tortuous vessels

a circumferential suture of 4-0 or 5-0 silk on an atraumatic needle was placed over the upper saphenous segment intramurally 0.5 cm below the lower margin of saphenofemoral valve or 0.2-0.5 cm below the ligated upper tributaries of the great saphenous vein.The suture was tightened gradually until there was no blood dumping back through the constricted incompetent valve. This procedure was benefited by lessening operative trauma and reducing blood loss during operation.We had operated on 67 tortuous saphenous veins in 54 patients from September 1987 to May 1992.The results were satisfactory with a longest followup of more than 4 years.All symptoms of the patients subsided and varicose ulcers

if any

all healed. There was no recurrence nor deep vein thrombosis found