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Varices operation, Miller's method (I)

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Surgery and Aesthetic Medicine Center Warsaw, Otwock

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We use a series of methods beginning from traditional streeping through hardly-invading  cryostreeping to EVLT* – endoluminal technique of intravascular vein closure by the use of a laser.  
Treatment method selection. Not all the patients shall be treated in the same way and a given technique of operation cannot be used with each patient. During consultancy with a doctor venous disease stadium and best method of its treatment shall be discussed. We are striving to achieve the best therapeutic effect that could coexist with perfect cosmetic effect. EVLT* procedure or cryostreeping lasts approximately 1,5 hour.  24 hours after the procedure crepes bandage is put on and then exchanged for a comfortable elastic bandage which patient shall be wearing for approximately 3 weeks. Next day patient is ready to return to normal everyday activity and to work after a few days.
Many people are afraid of anaesthesia, resign from the procedure in the event of narcosis or lumbar anaesthesia – „in the spine”. We have performed procedures of limb varices removal for many years in our clinic – even the removal of the greatest ones – under regional anaesthesia  which on one hand allows  for procedure performance on patients among whom another type of anaesthesia is contraindicated by reason of health problems and on the other, it allows to return home directly after the procedure. This type of anaesthesia can be linked with sedation, which increases comfort of procedure. As it was previously mentioned, every patient and every disease is different, it does not always require streeping or EVLT*. In this case we encounter a situation in which a starting point of lesions are inefficient perforators  (penetrating veins) linking deep vascular system with surface one, then the best method is performators closure under USG control and varices removal with the use of Muller’s method. This method relies on putting special hooks through pricks and removal of lesioned veins. This method leaves only small spots which are not visible after 2-3 months.  * it is an English abbreviation which means laser intravascular treatment.
 
Tiny lesions so-called reticular varices, telangiectasias and spider veins are removed with the use of other methods. Vessels whose diameter oscillates between 1to2 mm are best removed with the use of sclerotherapy and aethoksysklerol or sklero-vein specimen in a form of liquid or foam. For injections syringes with very thin needles are used thanks to which the procedure is almost painless. In the injected lesion inflammatory process starts which leads to vessel fibrosis and closure of blood flow in the vessel.
The process of closure lasts a few weeks and requires wearing special band in the initial week. Scleroterapy in the backlight of veins by VEINLITE LED VEINLITE device enables location of invisible in USG tiny supply vessels of spider veins and capillary rete visible on legs at the depth of up to 1 cm. Smaller vessels whose diameter is 0,3 mm to 1 mm are best closed by Nd-Yag 1064 nm laser having affinity to haemoglobin included in blood cells. The procedure relies on direct laser radiation of vessel filled with blood cells microinflammation that occurs leads to fibrosis and atrophy of vessel. Lasers used in this method possess different lightwave length that is why different affinity to water and haemoglobin. The effect we gain each time is, however, the same and relies on damage of internal layer of blood vessel, which leads to its fibrosis and atrophy.

Miller’s method under regional/tumescent anaesthesia
1 limb 476 €

Anaesthetist-intravenous anaesthesia (sedation + analgesia)    
1 limb 60 €


Advance fee: 10%


Warszawa


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