Minimally invasive solution for varicose veins, no longer embarrassed to wear short skirts Ms. Lin is a shopper in a large electrical shopping mall, usually need to work standing. 4 years ago, after she gave birth to a baby, she found that her leg veins had a tortuous protrusion, especially when standing very obvious, which brought her great distress, because she especially like to wear skirts. Ms. Lin had visited several hospitals and delayed the surgical treatment because she was afraid of leaving a large scar on her leg after the surgery, which would affect her beauty. As time passed, Ms. Lin not only felt that the veins in her legs seemed to protrude more obviously, but also felt a heaviness in her legs after standing for a long time, and there was a mild pigmentation of the skin color at her ankles. Ms. Lin learned from many inquiries that the Second People’s Hospital of Fujian Province has carried out minimally invasive treatment for varicose veins in the lower extremities, so she approached Dr. Wang Hongcheng, the chief physician. Director Wang performed laser cauterization of the saphenous vein trunk + microscopic hook removal of the superficial calf vein for Ms. Lin, and she was discharged from the hospital to work only 1 day after the surgery. After 1 month, it is now hard to see the surgical scar on Ms. Lin’s leg and she can wear her favorite dress again with confidence. Many people choose conservative treatment because conventional surgery is traumatic According to Dr. Wang Hongcheng, the incidence of varicose veins in the lower limbs is about 7% in the population. The main pathogenesis is the incomplete closure of the valves of the saphenous vein into the deep veins, which leads to a backflow of blood from the veins and increases the pressure in the veins, causing the veins to dilate and twist over time, called saphenous varicose veins. Varicose veins can be asymptomatic for a few years or even a decade, but when the lower extremity venous valves are damaged to a certain extent, a variety of complications often occur in a short period of time, such as intravenous thrombosis, thrombophlebitis, hyperpigmentation, venous stasis dermatitis, intractable ulcers, rupture and bleeding. Once these complications occur, the treatment of varicose veins becomes more complicated and sometimes difficult to cure. In the past, many varicose vein patients with no obvious symptoms or older patients with mild symptoms were often reluctant to undergo surgery, mainly because traditional varicose vein surgery is very invasive and leaves unsightly scars after surgery, so they delayed it until complications arose and had to be treated. But by then, the best time for treatment is often missed. The advantages of minimally invasive surgery will change people’s choice “When I first saw the minimally invasive treatment process for varicose veins in the outpatient operating room of the Center for Venous Surgery at Harvard University’s Massachusetts General Hospital, I was surprised and excited, and the emotion I felt at the time was, in a word, ‘surgery can be done this way! ‘” Director Wang Hongcheng said. Last year, when Director Wang was sent to the United States for further training in thyroid surgery, he had a chance to observe the minimally invasive varicose vein treatment procedure, and the huge contrast in surgical concept and technology made him determined to master this technology and serve patients after returning to China. The traditional varicose vein surgery is to strip the saphenous vein trunk while making multiple incisions to strip the varicose veins in the lower leg, this surgery is more traumatic due to many incisions and the patient’s hospital stay is usually about a week. So, what is the minimally invasive treatment of varicose veins? Director Wang said that the minimally invasive treatment of varicose veins is not actually a single surgery or treatment, but a combination of 2 to 3 minimally invasive treatments. ① Endovenous laser closure (EVLT) is a new technique that uses a special wavelength of laser to thermally cauterize and close the vein cavity through fiber optics. These techniques are mainly used for the treatment of the saphenous vein trunk in the thigh, but not for the superficial varicose veins in the lower leg. Micro-scarring of veins (Micro-) means that the superficial varicose veins in the lower leg are poked with an ophthalmic scalpel to make a small incision of about 2 mm, and the diseased vein is removed by hooking it with a special vascular hook. ③ Foam sclerotherapy is mainly used in clinical practice to supplement the treatment of small varicose veins that remain after surgery. The most common and ideal minimally invasive treatment for varicose veins in the lower extremities is a combination of laser or radiofrequency endovenous cautery of the venous trunk and microscopic scar removal of the superficial varicose veins in the lower legs, which can be done either as an outpatient treatment in stages or as a one-time treatment in a short-term hospitalization. However, it is not easy to carry out this minimally invasive treatment and medical units must not only have more expensive equipment such as laser or radiofrequency machines, portable ultrasound and special instruments for minimally invasive surgery, but also require the surgeon to master ultrasound skills so that this minimally invasive treatment can be done well. Many varicose vein patients are concerned about whether the surgery is minimally invasive and beautiful, but they also care a lot about whether the treatment is complete and whether it will recur in the future. On this issue, director Wang Hongcheng said that the minimally invasive treatment method currently introduced by the vein specialist of the second provincial hospital can effectively deal with all the lesions of the superficial vein system of the lower limbs, and as long as the vein lesions are not very serious, a complete treatment effect can be achieved and post-operative recurrence can be eliminated. Early surgical solution before complications arise Medications and compression stockings are the main means of conservative varicose vein treatment, but medications can only play an auxiliary role in the treatment of varicose veins in the lower extremities, while compression stockings, despite their exact therapeutic effect, need to be worn for life, which is troublesome and expensive to use, and many patients are allergic to the rubber components in compression stockings and cannot use them. Therefore, the vast majority of patients who initially wore compression stockings eventually opted for surgical treatment. With the development of varicose veins in the lower extremities, the blood from the deep veins flows back to the opening of the diseased saphenous vein and then flows backwards to the superficial venous system, forming an ineffective circulation and increasing the burden on the deep veins, which, over time, leads to or aggravates the degree of deep venous valvular lesions. The severity of deep vein lesions is an important factor in the recurrence of varicose veins after varicose vein surgery. Once the condition reaches thrombophlebitis, edema, hyperpigmentation, sloughing dermatitis or ulcers, in addition to increased pain for the patient, the recovery time after surgery and the cost of treatment for the patient may also increase exponentially. Therefore, in order to avoid these complications, the best option is to address varicose veins with early surgery before complications arise.