The Royal London gives patients new op

07 August 2009

PATIENTS with painful varicose veins across North and North-East London and Essex stand to benefit from a new, simpler operation now being offered at The Royal London Hospital, which involves almost no scarring and allows patients to leave hospital immediately.

The minimally invasive operation is used to treat venous reflux disease, where the tiny valves that normally force blood back up towards the heart no longer work efficiently. This can lead to the development of varicose veins, a condition which affects an estimated 20 per cent of adults.

The operation involves inserting a catheter (long wire) into the diseased vein through a small incision using ultrasound to guide it. The tiny catheter powered by radiofrequency (RF) delivers heat directly to the vein wall.

Delivery of the thermal energy causes the vein wall to contract and seal shut. Once the diseased vein is closed, blood is re-routed to other healthy veins.

Consultant Vascular Surgeon at The Royal London Hospital, Paul Flora, carried out the first operation using this technique in the Outpatients Department last week.

Commenting on the procedure, Mr Flora said: "The patient was able to walk out of the hospital shortly after the operation, which took just under an hour and was done under local anaesthetic. The scar the procedure leaves is also tiny - about 3mm.

"As well as reducing treatment and recovery time for the patient, by carrying out the procedure in Outpatients for the first time, we are freeing up capacity in our operating theatres and on the wards. The overall benefits are a reduction in the surgery waiting times for other patients and a cost-saving for the Trust."

Traditional operations to remove varicose veins use a technique called 'vein stripping' which is carried out under general anaesthetic in operating theatres, can be quite painful and although done as a day stay procedure can have a recovery period of up to six weeks.

Laser surgery is an alternative endovenous (key-hole) treatment option but requires a specialist setting not available in Outpatients because of the strict safety precautions needed.

Mr Flora added: "In many people varicose veins present only a cosmetic problem but in severe cases can impact heavily on a person's lifestyle, especially when the person's job requires extended standing. They can cause skin ulcers around the inner ankle or calf and intense pain in the legs."

"Vast resources are spent on healing patients who have developed skin ulcers. This new technique will allow us to treat the superficial venous system promptly meaning patients won't develop these terrible ulcers."

Mr Flora hopes to treat up three patients each week using this technique in the Outpatients Department at The Royal London.



Almost all patients with varicose veins are suitable for this procedure, with about a third of patients suitable for this procedure in this outpatient setting.