The anatomy of the superficial veins
around the left thigh and groin

The diagram shows the sapheno-femoral junction (SFJ) where many of the superficial veins come together before joining the major deep vein of the leg, the femoral vein (FV).

The flow of blood at this junction is controlled by a one-way valve which is designed to direct blood inwards and upwards, helping it to return towards the heart.

If this valve fails to function properly, some blood is able to flow back down into the leg, increasing the pressure in the superficial veins and their branches.

The long saphenous vein (LSV) is one of the main superficial veins in the thigh. If extra blood is forced into it by a leaking valve at the SFJ, the vein stretches and further valves within it become distorted and begin to leak. Blood is then able to flow further down the leg in the wrong direction, eventually filling and distending more and more branches, causing the appearance of varicose veins in the thigh and calf.

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Surgical diagram -
sapheno-femoral ligation

A 2-3 cm incision in the groin crease is held open by retractors.

The superficial vein branches forming the sapheno-femoral junction have been dissected free, divided and tied. The junction itself has been tied flush with the femoral vein.

The long saphenous vein is held in a haemostat in preparation for stripping of the vein down to the knee.

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High pressure in the superficial veins has caused typical skin changes in the "gaiter" area above the ankle with eczema, pigmentation and superficial skin ulceration.

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