VNUS closure
This is a relatively new minimally invasive technique for surgically treating varicose veins. It was developed in California and replaces the high tie and strip part of the operation.
The technique involves the passage and positioning of a probe in the long saphenous vein. This is done under ultrasound guidance in the operating theatre. To make sure that the overlying skin is not damaged by the heat, sterile salt solution may be injected beneath the skin to push the vein further away from the skin. The procedure cannot be used for the short saphenous vein because of the proximity to very important nerves at the back of the knee. It is very useful for treating recurrent varicose veins arising from the groin as it can avoid a redo groin exploration (this is more risky than first time surgery).
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Radiofrequency generator and probes |
End of the probe |
Once the probe is positioned, the thigh is compressed with an elastic bandage to empty the vein. The radiofrequency generator produces electric current that causes heating at the end of the probe. This temperature is sensed by the probe and displayed on the generator. A temperature of 85oC is used to destroy the vein from inside. The probe is slowly pulled down the vein.
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| The probe is positioned | The probe is activated | The probe is slowly pulled down the vein |
The elastic bandage is removed and the vein scanned to make sure it is blocked.
The avulsions are then carried out as normal. The avulsion sites are dressed with steristrips. The leg is bandaged with crepe (cotton bandage) for 2-3 hours to limit the bruising from the avulsion sites. Stockings are then applied for a couple of weeks whilst any superficial bruising settles.
The advantages of this procedure are:
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No groin wound infection |
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Little pain - no stripping involved |
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Faster recovery and return to normal activities - usually in 48 hours |
Other than these differences the other complications are the same as for open surgery.
As this is a relatively new procedure, some insurance companies my not pay for it. You will be advised about this by your consultant and you may be expected to pay the supplement yourself.
More information can be obtained form the VNUS website at www.vnus.com
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