The set of rules of modern surgery will have a perfect result:
1- Local anesthesia by tumescence permit to,operate varicose veins without bleeding which avoids hematomas and pains.
2- Thanks, a precise preoprative cartography, the incisions will be puntiformes micro-incisions
3- The great experience of soft surgery with little trauma allows to have the best aesthetic result.
The micro-incisions will no longer be visible two to three months after the operation Only very fine, deep absorbable threads will be used and no threads will be placed on the skin of the steristrips alone to ensure that there is no mark. The skin spots are exceptional because there is no hematoma. This excellent aesthetic result also makes it possible to operate varicose veins under local anesthesia at:
• Of the face
• Around the eye
• Of the chest.
The experience of Dr. Gabriel Lasry in the cosmetic surgery of varicose veins around the eye of the face is the best guarantee of a good aesthetic result on the varicose veins of the legs.
It all starts with a consultation with Dr. Gabriel LASRY which is essential.The first consultation lasts between 30 and 45 minutes, Dr. LASRY will explain in simple terms the current new techniques:- pure local anesthesia (only the vein is anesthetized)
- without hospitalization,
- under local anesthesia,
- walking is immediate and painless.The anesthesiologist will be present when operating and a local anesthetic will always practiced for operating of varicose veins with calm and serenatmosphere . A simple hypnosis is sometimes possible.
In the operating room of varicose veins, soft music will calm the potential stress of the patient.This surgery will respect all the classic rules of cosmetic surgery (micro incision, no thread on the skin).
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
- 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.
This surgery is minimally invasive because it is interested only in diseased veins and always respects healthy veins or shortly inflated. In fact, these healthy veins may possibly one day be used as arterial substitute (bypass) .
Patients come in the morning and go out at night (the same day) which performs outpatient surgery.
The leg has no bruising; only a few “blue areas” or bruising may occur.
It is not necessary to wear strips varix at the output of the clinic the evening. The patient will come out in the evening with stockings that will allow him to wear normal shoes and, of course, walk right out.
Professional interruption is reduced from three to eight days in our experience (more than fifteen thousand varicose operated outpatient under local tumescent anesthesia).
The number of recurrence is low (less than 5% in 10 years), provided that the gesture is controlled by an ultrasound on the fifteenth day, and, of course, that the complementary sclerotherapy is performed by the angiologist.
This surgery varicose respects the rules of plastic surgery (no wire on the skin, only steristrips, absorbable).
Finally, we are one of the few teams to achieve it regularly. The operation is controlled by a Doppler between the fifteenth and thirtieth day ensures that all diseased veins have been removed and will be the starting point of the postoperative follow-up by the patient’s angiologist (postoperative sclerotherapy).
This whole procedure will alone ensure that no additional fees (excluding that of the intervention) will be asked if a very rare recurrence occurs during long term.
It is a specialist who is named angiologist that practices it.
Only this Doppler is able to measure the size of varicose veins, to clarify the meaning of movement and locate the leakage points which confirms, the incontinence of the varicose vein,
The indication of a thoughtful and appropriate treatment can be performed after the doppler-ultrasound,
This treatment will be adapted on the mapping of varicose veins that will be displayed on a diagram. This card will show the direction of flow in the veins (up or down and, of course, the precise location of leakage points)
This mapping or tracking is essential and must be done at all stages:
– Before treatment choice to locate the leak points and guide treatment (sclerosis, endovenous laser, or varicose vein surgery.)
– It will be practiced before or the morning of the endovenous laser or varicose vein surgery to guide the surgeon’s by venous mapping (just as plans for an architect).
This Doppler ultrasound tracking will show the positional anomalies of varicose veins that are very common and can lead to relapse if they are not localized.
– It will guide the surgical procedure, not to forget because varicose veins are not all visible to the naked eye; of course it can practice aesthetic scars puntiformes (as they have been well guided by locating)
– It will also be performed after the operation of varicose veins, to control the surgical procedure, that is to say, check that all the veins have been removed.