Background: Subfascial endoscopic perforator vein surgery (SEPS) has numerous advantages. Minor complications like tenderness on palpation, pain when walking, lower limb muscle tension, surgical wound suppuration, hypoesthesia and paresthesia of the middle ankle and the plantar part of the foot are recordable. But none of these complications is life-threatening. Another interesting complication was observed in our clinic.
Case Report: A patient underwent bilateral SEPS procedure due to perforator vein insufficiency. Twelve days after operation fluctuation was observed on both sides. Fluid collection was confirmed with ultrasound. Biochemical evaluation of fluid revealed transudative collection. Endoclips are possible foreign-bodies causing immunological reactions which lead to fluid collection.
Conclusions: These and other complications with endoclips lead us to believe that electrosurgical bipolar vessel closure could be more effective in vascular procedures and these devices, logically, would not cause foreign body reactions. Furthermore the use of such devices offer the possibility to divide and seal in a single maneuver.

Keywords: Subfascial Endoscopic Perforator Vein Surgery, SEPS, Transudative Collection