Minimally invasive treatment of varicose veins and skin ulcers in the lower extremities
Varicose veins of the lower extremities are a pathological varicose state caused by excessive tortuous expansion of the superficial veins of the lower extremities of the human body, which mostly occurs in people who are engaged in long standing work, high intensity of physical activity, or long standing and less sitting, and is closely related to occupation and genetics; the main cause of the disease is the increase of venous fluid pressure in the lumen of the distal veins of the extremities caused by the weakening of the venous walls, incomplete closure of the venous valves or valve defects.
The incidence of superficial varicose veins of lower extremities has obvious geographical distribution characteristics, there are great differences between different regions, the incidence of the disease is much higher in industrially developed countries than in developing countries, in China, the incidence of superficial varicose veins of lower extremities is between 10%-20%, women are twice as much as men, the incidence of venous ulcers is 0.5%-3.0%.
The main clinical manifestations: the lower limb superficial veins are progressively dilated, tortuous and bulging, with the lower leg being heavy, and accompanied by different degrees of lower limb soreness and swelling, weakness and other discomfort; as the lower limb symptoms gradually aggravate, pigmentation, eczema, subcutaneous hard nodes can appear in the lower leg skin, and ulcers can be formed when serious (commonly known as “old rotten feet”).
Treatment misconceptions.
Myth 1: Hot water soaking feet can reduce varicose veins
Many patients think that hot water soaking feet is not only comfortable but also reduces varicose veins, and they think that the hotter the water is, the better it is, which is actually an incorrect idea. We all know the reason of heat expansion and cold contraction, if we soak in hot water again, the blood vessels will expand, which will aggravate the varicose veins and swelling.
Myth 2: Massage can reduce varicose veins
Nowadays, massage stores are everywhere, massage can really relieve the fatigue of the day and reduce the discomfort caused by varicose veins, but for the varicose veins that have been protruding, there is not much benefit, especially for the varicose veins that have redness and pain in the lower limbs, which may be thrombotic superficial phlebitis, and if the thrombus is squeezed into the deep veins during the massage process, it will cause pulmonary embolism with the blood flow to the pulmonary artery, leading to death and other serious consequences.
Misconception three: “a needle” to remove varicose veins
Sclerotherapy injection can make the protruding veins “disappear”, the principle is that the sclerosing agent makes the blood vessels bond together, the surface is not visible, but not completely removed. The advertised “one shot” does not completely remove the varicose veins, but is also prone to recurrence and complications of phlebitis, making surgery more difficult and leading to deep vein thrombosis or pulmonary embolism in serious cases, which can be life-threatening.
In order to meet the trend of medical development in the 21st century, minimally invasive technology has emerged to meet the needs of the majority of beauty lovers and to reduce patient pain. Minimally invasive technology refers to the combination of advanced equipment and instruments with skillful surgical techniques to minimize the damage caused to human tissues, fully reflecting the characteristics of minimally invasive and cosmetic surgery. Therefore, this technique is very suitable for the treatment requirements of elderly patients and beauty lovers.
The minimally invasive technology carried out by our department for the treatment of lower limb superficial varicose veins and skin ulcers is currently the leading one in southwest China and advanced in China. The treatment instrument and microwave treatment instrument are introduced to provide superior conditions for the minimally invasive treatment of lower limb superficial varicose veins.
1.Minimally invasive percutaneous transillumination negative pressure spinotomy
The Trivex vein spin-cutting system (Smith-Nephew Company, USA) is adopted, which is mainly composed of power main unit, spin-cutting head, perfusion lighting rod and perfusion pump. Using our center’s original 50% residual rate of spinotomy, we follow the technique of “three-point linear”, “two-point linear”, and “three-point triangular” to perform varicose superficial veins and It has the advantages of low recurrence rate, small incision, short operation time and avoiding skin lesion area incision.
2.Minimally invasive saphenous vein closure with double wall and double lumen isolation by semi-exfoliation
The core technology of this technique is semi-preserved stripping, which means that the lumen of the saphenous vein is closed by the saphenous vein itself, and at the same time, the genus and traffic branches of the saphenous vein are closed, which plays an important role in protecting the saphenous nerve in the lower leg and reduces the pain and numbness caused by subcutaneous nerve injury after surgery.
3.VNUS CNC radiofrequency closure surgery
VNUS CNC radiofrequency closure instrument of the United States is used, which consists of two parts: computer-controlled intracavitary closure radiofrequency generator and 2mm and 2.7mm diameter closure electrodes, the radiofrequency probe is introduced into the varicose vein lumen through the catheter, and the power is delivered through the radiofrequency generator and radiofrequency treatment tube, the radiofrequency probe releases heat, generating heat energy to cause hyperthermia in the local tissue in contact with the electrode, causing the vein to collapse, the lumen to contract and mechanization and fibrosis of the occluded vein.
4.SurgiLas Semiconductor Laser Closure
Using the 810nm semiconductor laser treatment instrument mainframe and laser fiber, the thrombosis in the lumen of the vein and the thermal damage to the vein wall will cause extensive thrombosis in the vein and finally occlude the vein to achieve the treatment purpose.
At the same time, our center’s original concept of “multi-dimensional minimally invasive technology for the treatment of varicose veins in the lower extremities” uses different combinations of modern minimally invasive technologies to complete the treatment of the disease.