Laser surgeries of the varicose veins of the lower limbs – (endovenous closure of the veins, EVLT,ELVESS, EndoVenous Laser Treatment) – using laser with a wave- length of 1470 nm is a safe, effective and modern method of treating the venous disease.
The treatment progression using this method is rapidly growing in Poland and abroad. The first such surgery was performed in the USA in 2002.
In 2010 in the USA about 90% of laser surgeries was performed using this particular technique and only 10% of the surgeries was conducted using the traditional stripping method (the removal of the vein).The traditional method was connected with many unpleasant factors such as: the hospital stay, greater pain, larger number of complications and recurrence of varicose veins, anesthesia/ general anesthesia or spinal anesthesia/, greater post-operative trauma and longer come back to normal physical and occupational activity.
In the laser method, the vein is not removed, but it stays on its place and is shrunken using the laser light. Later on the vein undergoes fibrosis and is being closed off.
The use of 1470 nm laser is connected with minor post- operative petechiae and almost no pain.
Laser surgery of the lower limbs is less invasive than the traditional method, related to smaller amount of post- operative complications.
Having followed the rapid progress of the global phlebology, I included in my offer the most advanced treatment methods of varicose veins, namely, laser surgeries of varicose veins.
The diode laser Swing 17 with the wave- length 1470 nm is being constantly used in my medical and surgical practice. Due to this particular kind of laser,
the laser ray can be dosed in a very careful and accurate way. That makes the therapy safe and very reliable for the patient.
The advantages of the surgery using EVLT laser:
- AMBULATORY NATURE OF THE TREATMENT /NO HOSPITAL STAY/.
- THE SURGERY IS PERFORMED UNDER LOCAL ANASTHESIA .
- THE TREATMENT/ SURGERY LASTS ONLY 25-40 MINUTES.
- HIGH TREATMENT PERFORMANCE / 93-98%/.
- MINIMUM RISK OF COMPLICATIONS
- IMMEDIATE RETURN TO HOME AND TO NORMAL PHYSICAL ACTIVITY.
- FAST RETURN TO OCCUPATIONAL ACTIVITY
- SMALL PAIN, USUALLY NOT REQUIRING THE USE OF ANALGESICS.
QUALIFICATION FOR THE SURGERY
The operational treatment of varicose veins using EVLT 1470 nm laser is conducted after a detailed consultation with a specialist and after performing Doppler’s ultrasound of lower limbs. Due to this procedure about 75% of patients can be qualified to the treatment.
Pacemaker is not a contraindication to the surgery.
The surgery can be performed regardless of the age of the patient and the season of the year.
Laser surgery of varicose veins can be performed on both legs due to minimal surgical trauma.
CONTRAINDICATIONS TO THE SURGERY
- BAD HEALTH CONDITION OF THE PATIENT
- ONGOING VENOUS THROMBOEMBOLISM
- OLD THROMBOTIC LESIONS THAT PREVENT THE INSERTION OF LASER FIBER PREGNANCY
- ALLERGY TO ANASTHESIA
- THE STATE HYPERCOAGULABILITY OF BLOOD
- ADVANCED VASCULAR DISEASE, ATHEROSCLEROTIC ARTERIAL DISEASE.
- TORTUOSITY VEIN.
THE COURSE OF LASER SURGICAL TREATMENT
- localization of the vein using ultrasound
- the insertion of special catheter to the vein through a small incision or a puncture of the skin with a length of about 5mm
- the insertion of the laser fiber through the catheter
- administration of local anesthetic around the vein
- laser launch connected with its slow withdrawal from the vein light- laser light closes the whole vein off
- the compression is being administered after the surgery (stocking or a band)
- When dealing with huge varicose veins the surgery can be complemented with sclerotherapy or through mini phlebectomy ( the removal of dilated venous plexuses of the skin incision point) under local anasthesia. 2-3 mm skin’s incisions after mini phlebectomy are covered with sticking plasters “steri-strip”, no stitches required.
COMPLICATIONS AFTER LASER SURGERY
Although post- operative complications are very common, they occur very rarely after the laser surgery of varicose veins and can be very minor. Some of them such as: skin bruising, hematoma, ecchymosis, induration and swelling along the course of the vein, hyperesthesia, hyperpigmentation and prolonged pain can be enumerated.
Some more severe complications can occur. To those bleeding, infection of the skin, burns, venous thrombosis or pulmonary embolism can be included. Nevertheless, they are not common.
PREOPERATIVE PREPARATION OF A PATIENT
–the depilation of the limb to the groin ( done on the day of the surgery) or chemical depilation using depilatory creams
-discontinuation of hormone therapy –discontinuation of birth control pills minimum 3 weeks before the surgery
-discontinuation of the acetylsalicylic acid derivatives (aspirine, polocard, acard, bestpirin etc.) one week before the surgery
-before the surgery drink about 1,0 liter of liquids (in the afternoon)
-the patient should arrive with the accompanying person /the patient cannot drive a vehicle
-before the surgery 90- minute walk is recommended
-DO NOT eat about 6h before the planned surgery
-taking the blood tests: morphology, clotting time APTT
PROCEDURE AFTER LASER TREATMENT
After laser surgery compression stockings or elastic bands are administered for the first 48h and then their use is desirable for at least 14 days.
The first individual bandage change within 24 hours after surgery.
In case of pain it is recommended to use painkillers such as paracetamol, Ibuprom.
For a period of 7-10 days prevention of thromboembolic disease is used- low molecular weight heparin is subcutaneously injected.
After the procedure immediate return to normal activity is advisable. Patient together with a friend come back home and the next day the patient returns to work.
After 7-10 days from the surgery the control visit is planned. The visit is free of charge.
The cost of qualification to the treatment using Doppler’s ultrasound – 200 PLN
The cost of laser removal of the varicose veins – 3200 – 3500 PLN