Laser (Endolaser ELT)
Laser operation without skin incision
In the treatment of trunk varicosity we have been using endolaser since 2001. We use a 1470 nm diode laser with radial double-ring fibers.
Prof. Dr. Flor presented his experience with four generations of laser systems during numerous international congresses.
Within the last years no other technique revolutionized the treatment of varicosity as did the Endolaser. Modern laser is used whereas formerly the groin (inguinal) would be surgically opened (crossectomy) to strip the vein subsequently (stripping), which often caused haematomas and wound-healing disorder. Patients had then to wear compression stockings for up to three months and faced longer convalescence periods.
Principle of endolaser treatment
A small puncture allows the insertion of a laser probe into the long vein on the inner side of the leg (vena saphena magna) or into the calf of the lower leg (vena saphena parva). The laser energy of a distinct wave length emitting from the tip of the probe causes diminution of the vein wall. The surgeon can, by means of ultrasound, examine the success of the laser treatment right during the intervention. Contrary to foam sclerosing, the laser energy can be directed precisely to a distinct position – no systemic side-effects or pain arise.
Hasn’t Laser existed for a long time?
Endolaser should not be mistaken for the “transdermal“ laser which introduces the laser energy from outside, via the skin. Such transdermal laser are appropriate in the treatment of smallest veins and spider burst, yet not a substitute for the surgical treatment by inguinal incision and stripping!
Sustain veins by means of laser
Based on an exact ultrasound examination, laser energy is precisely induced into the diseased vein segments. Sound vein segments may be maintained, overstrained venous valves or vein segments may in part recover.
Interventions are always carried out under tumescence anesthesia. Greater amounts of a highly diluted local-anesthesia agent ensure gentle and painless interventions.
Intervention by means of Endolaser is still a surgical method. The intervention is to be carried out under aseptic (germfree) operating-room conditions.
An anaesthesiologist attends most of our interventions. We consider that a service for our patients. Patients are under enormous psychic stress. This is why many interventions are carried out under sedative anesthesia. As a result of year-long cooperation with our anesthesists, the sedative alganesthesia will be synchronized with the degree of local anesthesia to guarantee high patient satisfaction.
Inpatient or outpatient treatment?
Contrary to the classical operating techniques (crossectomy and stripping), Endolaser treatment may in many cases be carried out in an outpatient way.
One leg only or both legs?
As endolaser interventions entail only little stress, gentle treatment is also possible in both legs even in cases of expanded findings.
Endolaser and Miniphlebectomy
Varicosity is only seldom confined to the trunk veins (vena saphena magna, vena saphena parva). In most cases the lateral branches of the trunk veins are affected too. These lateral branches should be removed by miniphlebectomy during the same intervention.
They are not necessary if only Endolaser treatment is performed, yet still advisable for a couple of days. In combination with miniphlebectomy they should be worn for 1-3 weeks, the first three to seven days they should be worn during day and night. Cumbersome slipping bandages are out of use. We apply modern stockings, specially developed for surgical purposes.
Endolaser in the cold season only?
Endolaser interventions are also carried out in the warm season, as compression stockings will not have to be worn as long as with traditional operation methods.
Endolaser and sports?
We recommend light physical activities straight after the intervention. Hometrainer, a little cycling or walking are also desirable.
Success rate of endolaser treatment
Success rate while using the modern vein systems is about 98%. (Literature frequently states still better occlusion results of even 100%.)