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| Advantages of local anaesthetic |
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Cost:-
By avoiding hospital costs and the costs of anaesthetists, at The Whiteley Clinic we have been able to reduce the costs of the total local anaesthetic treatment to approximately 60% of the equivalent operation performed in our local private hospital using general anaesthetic. This alone should be a big enough reason for private medical insurers to support the new local anaesthetic vein surgery revolution.
Unfortunately as the majority of surgeons are still not offering this sort of procedure, many of the insurers are still slow to understand the benefits, both to the patient and to themselves, of supporting these innovations. Over the next few years this situation will change as doctors all start to use these techniques, patients start to demand them and insurance companies get comfortable with the improved results and decreased costs. Until that time, it is up to patients to make sure that they ask for specialists who perform these procedures and how have been properly trained in them – and to make sure that their insurers realise the reduced costs that are involved.
Pain relief:-
Compared to the high saphenous tie and strip, the minimally invasive techniques are very much less painful. Although occasionally endovenous laser therapy can be very painful, it is usually considerably less painful that the old tie and strip - and it does not have the groin incision of the old technique. VNUS Closure® FAST has virtually no post-operative pain, neither does RFS nor phlebectomy. Virtually all of the other techniques have very low pain scores and so most of the local anaesthetic techniques are now regarded as “walk-in/walk-out surgery”. Most patients are able to get back to relatively normal life within twenty-four hours of their procedures which is quite a remarkable difference from the two to four weeks off that many people used to have after stripping.
Low complication risk:-
As patients walk in to the procedure room and then walk out some thirty minutes to one hour later, eating drinking normally, moving normally and wearing support stockings, the complications that we are seeing from local anaesthetic vein surgery, are very low compared to what we are used to with general anaesthetic vein surgery.
Deep vein thrombosis (DVT) is related to immobility and so walk-in/walk-out surgery of course reduces this risk considerably. As all the wounds are approximately 1 to 3 mm in size, and there are no big groin wounds or wounds behind the knee, wound infection rates are very low and, even if they occur, are not very serious. Under general anaesthetic nerve damage is a well recognized complication because the patient is unable to say if a nerve is being touched. Under local anaesthetic, although the local anaesthetic is very good at numbing the skin, fat and veins, it is not strong enough to completely stop the nerves working and, if a nerve is touched during the procedure, the patient is able to communicate this and so nerve damage is much less likely.
Recovery:-
Due to the very small incisions, very small amount of bruising and therefore very low pain scores, patients are able to get back to normal life very soon after their local anaesthetic surgery in the vast majority of cases.
Cosmetic result:-
Although all surgery takes the same time to heal, the very small incisions mean that an excellent cosmetic result is almost always obtained at the end of the procedures, provided the whole course of treatments have been followed.
Efficacy:-
At The Whiteley Clinic we are finding that the local anaesthetic procedures are highly efficacious. Although the “gold standard” of high saphenous tie and strip is always quoted, our research showing that approximately a quarter of the people having high tie and strip grow their veins back again within one year, means that the 98%-99% success rate we see with the local anaesthetic procedures, look even better than expected initially.
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