LASER SURGERY FOR VARICOSE VEINS

Varicose veins are prominently dilated, tortuous veins seen in the legs .The prevalence is as high as one in eight people. They can cause an array of problems ranging from simple leg pain,Pigmentation, ulceration etc. Varicose veins can be symptomatic or asymptomatic .

What is EndoVenous Laser Ablation (EVLA/EVLT) ?

Over the last 100 years, open surgery for varicose veins was the procedure of choice .It required general or spinal anesthesia and longer time to recover. Open surgery  was painful , non cosmetic as it needed number of large incisions to remove veins. However this barbaric operation has largely been replaced by laser surgery today, which is less painful and has a lower incidence of recurrence`

Laser surgery for varicose veins is called EVLA stands for Endovenous Laser Ablation or EVLT, or endovenous Laser Therapy. It is a method of treating varicose veins using laser under local anaesthetic – and has many advantages over the old and out of date stripping method of surgery.

Enormously dilated veins with skin lesions (Venous Eczema)

Venous ulceration with skin discolouration (Lipodermatosclerosis)

Irreversible skin changes with leg swelling secondary to varicose veins

Recurrent venous ulceration due to untreated Varicose Veins

Grossly dilated Varicose veins with ulcer

Before ……………………………………After

Procedure followed in our Clinic.

We Perform laser under local anaesthetic or regional block as a ‘Walk-in, walk-out’ technique.

Initial mapping of the veins are done using Duplex Ultrasound.

Under ultrasound control, a needle is put into the vein near the knee or ankle. A wire is passed into the vein and a long ‘sheath’ is passed up the vein to the top. This ‘sheath’ is a thin tube about the width of a biro refill.

The ultrasound is used to position the end of the sheath exactly.

Local anaesthetic is injected around the vein – again using ultrasound to make absolutely sure the fluid is in the right place.

This technique is called ‘Tumesence’ or ‘Tumescent anaesthesia’.

Once the anaesthetic is in place, the laser fibre is passed up inside the sheath until it comes out of the top. The fibre is fixed to the sheath and the laser is switched on.

The sheath and laser are then pulled back at an exact rate, making sure the vein is completely destroyed – but without damaging the surrounding tissues.

How long should I stay in hospital ?

As laser surgery is performed under local anesthesia and doesn’t require any major incision, one can be discharged on the same day or the very next day of admission depending on his/her comorbidities.