Dr GABRIEL LASRY

 Vascular surgeon 

237 Bd zerktouni - Rond point racine -Casablanca - Morocco
Tèl : 0522 29 26 85 - Gsm :+212 664 05 03 79

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The tumescent local anesthesia is fundamental.

This is a technique that only allows a “traumatic” surgery. This is a surgery that, although complete, in our experience, it has systematically replaced general anesthesia or spinal anesthesia.

Indeed, spinal or general anesthesia, apart from these specific technical risks always causes dilation of varicose veins which increases the bleeding during the operation and often results in hospitalization for a few days.

This bleeding often causes a hematoma that is a source of pain and work stoppage or long social disability. Recurrences are much larger (30 to 50% in five years). Do not confuse the massive local anesthesia (epidural or spinal anesthesia) with this tumescent local anesthesia that is performed only along the veins. It allows anesthetizing only the varix operated with this anesthetic around the vein which is highly localized

 

tumescence mod copie 2 540x280

The goal is:Take off the vein that we will not need to be pulled off,

Closing the varix which contains at this time, no blood,

Hematomas are exceptional and only some “blue areas” may appear.

The tumescent local anesthesia facilitates the intussusception; which involves removing the vein in the back (such as a sock or a glove finger)

This is achieved by a yarn which has passed within the vein and allowing the return inside its light.

This is quite different from the stripping that passes it outside of the vein and damages most often fat peri-nerve or nerves satellites of the vein.

In stripping, hematoma and pain are common types of neuralgia.

However, intussusception with tumescent local anesthesia avoids hematoma and pain as neuralgia.

This stripping is so often practiced, but should disappear from surgical practice today

If precise mapping was performed preoperatively combined with a local anesthetic action tumescent, the varicose vein surgery will be softer, because the Doppler tracking or marking practiced the day before (drawing of the vein on skin) permits to find the smaller veins and the ones that are most buried by a single micro-incision.

This tumescent local anesthesia is still practiced by our team because it is limited around the vein. It may, at the request of the patient, be supplemented by a small “neuroleptic analgesia” so the patient “does not see anything or hear anything” if he wishes. In 20 to 30% of cases, this sedation is practiced to eliminate any possible apprehension of the patient.

In all cases, this surgery is done under tumescent local anesthesia, always minimally invasive and practiced with the most possible softness.

Anyway, this gentle surgery under tumescent local anesthesia is always minimally invasive and also aesthetic.

 

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Localisation

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Réalisé par Ismail Barahou

les varices esthetique au Maroc dr Gabriel Lasry chirurgie vasculaire

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The tumescent local anesthesia is fundamental.

This is a technique that only allows a “traumatic” surgery. This is a surgery that, although complete, in our experience, it has systematically replaced general anesthesia or spinal anesthesia.

Indeed, spinal or general anesthesia, apart from these specific technical risks always causes dilation of varicose veins which increases the bleeding during the operation and often results in hospitalization for a few days.

This bleeding often causes a hematoma that is a source of pain and work stoppage or long social disability. Recurrences are much larger (30 to 50% in five years). Do not confuse the massive local anesthesia (epidural or spinal anesthesia) with this tumescent local anesthesia that is performed only along the veins. It allows anesthetizing only the varix operated with this anesthetic around the vein which is highly localized

 

tumescence mod copie 2 540x280

The goal is:Take off the vein that we will not need to be pulled off,

Closing the varix which contains at this time, no blood,

Hematomas are exceptional and only some “blue areas” may appear.

The tumescent local anesthesia facilitates the intussusception; which involves removing the vein in the back (such as a sock or a glove finger)

This is achieved by a yarn which has passed within the vein and allowing the return inside its light.

This is quite different from the stripping that passes it outside of the vein and damages most often fat peri-nerve or nerves satellites of the vein.

In stripping, hematoma and pain are common types of neuralgia.

However, intussusception with tumescent local anesthesia avoids hematoma and pain as neuralgia.

This stripping is so often practiced, but should disappear from surgical practice today

If precise mapping was performed preoperatively combined with a local anesthetic action tumescent, the varicose vein surgery will be softer, because the Doppler tracking or marking practiced the day before (drawing of the vein on skin) permits to find the smaller veins and the ones that are most buried by a single micro-incision.

This tumescent local anesthesia is still practiced by our team because it is limited around the vein. It may, at the request of the patient, be supplemented by a small “neuroleptic analgesia” so the patient “does not see anything or hear anything” if he wishes. In 20 to 30% of cases, this sedation is practiced to eliminate any possible apprehension of the patient.

In all cases, this surgery is done under tumescent local anesthesia, always minimally invasive and practiced with the most possible softness.

Anyway, this gentle surgery under tumescent local anesthesia is always minimally invasive and also aesthetic.