By this technique, the removal of the great saphenous vein or the lesser saphenous vein, namely of the main vein which displays valve insufficiency and has resulted in the appearance of varicose veins on the skin surface, has been replaced by ablation of the vein by means of energy laser application directly at the venous lumen.
The method is carried out by ultrasound guidance through all its stages, which are as follows:
- Transcutaneous puncture of a vein by a venous needle by ultrasound guidance and insertion of the sheath
- Insertion and advancement of the laser fiber until the junction of the saphenous vein with the femoral vein
- Injection of Tumescent anesthesia, a special anesthetic solution around the vein and along the entire length of the vein by ultrasound guidance
- Laser activation and withdrawal of the fiber in a specific speed, destroying the vein
The continuous intraoperative ultrasound guidance, provided it is of high quality, guarantees high precision and safety during all the stages of the operation.
The operation is completed by the microphlebectomies of the varicose veins: at the site of the varicose veins is carried out an injection of Tumescent anesthetic solution and following this the varicose veins are removed by a microtechnique through tiny holes 1 millimeter in diameter.
The laser technology used during the operation is the cutting edge technology. The produced laser beam has a wavelength of 1470 nm, aiming at the water and not at the blood, fact that guarantees the success of the operation and a painless postoperative period. At the tip of the innovative fiber Elves Radial are located special specula which disperse the laser beam at 360 degrees, affecting in a homogeneous way the entire perimeter of the vein wall.
The advantages of the endovenous laser treatment compared to the traditional saphenectomy are of great significance:
- The operation is painless and is carried out with specific local anesthesia. Usually, the anesthesiologist of the team administers light sedation. The administration of general or regional (spinal or epidural) anesthesia is not necessary any longer.
- The operation is extremely safe and has minimal to no complications.
- The patient ambulation is immediate and he can walk just after the end of the operation.
- The immediate postoperative period is painless. As a matter of fact, the overwhelming majority of the patients do not take any painkillers the day after the operation.
- The patients usually can leave the hospital within one to two hours after the operation.
- They return almost immediately to their everyday activities while they can return to work after one to two days. The only requirement is that the patient must not lift anything heavier than 5 kilos and has to wear elastic stockings for two weeks.
- Provided that no surgical incisions or stitches are performed, the cosmetic result is excellent, since the resulting scars will be almost indistinguishable a few months after the operation.
- The possibility of facing a recurrence after the endovenous laser treatment of the varicose veins is smaller compared to the typical saphenectomy.
It should be noted that the endovenous laser treatment of the varicose veins is a method requiring high technology infrastructure as also strong technical skills/expertise of the vascular surgeon.
It should be highlighted that, according to the official guidelines of the Vascular Community of the United States and the American Venous Forum, the use of endovenous laser treatment is recommended for venous insufficiency instead of surgical treatment (Directive 11.2 – Gloviczki et al, Journal of Vascular Surgery, May 2011).