ItalianoAblation Sélective des Varices sous Anésthesie Locale
- TRADITIONAL THEORY
- A.S.V.A.L. METHOD
- PRINCIPLES OF A.S.V.A.L. METHOD
TRADITIONAL THEORY
The traditional surgery is based on the principle that the varicose veins spread from top to bottom (downward evolution), that is, from the top of the saphenous vein in the groin, up to affect progressively smaller collateral veins in the lower level of the leg, which are the real varicose veins, superficial and therefore visible.
This theory does not explain the numerous cases of varicose veins with saphenous veins not affected by the disease.
The radical solution is the intervention of high ligation and stripping of the saphenous vein and phlebectomy of varicose collateral veins side, leaving the remaining veins return blood to the heart .
The intervention is relatively heavy, requiring anesthesia and hospitalization.
A.S.V.A.L. METHOD
We start from the principle that varicose veins are propagated, on the contrary, from the bottom upwards (upward evolution), thus from collateral varicose veins of the leg to the saphenous vein.
The solution is easy: the method A.S.V.A.L. only aim to eliminate collateral varicose veins, considered at the origin of the disease, and that are the cause of clinical and aesthetic disorders, simply under local anesthesia.
The saphenous vein is preserved: even if it is affected by varicose disease, simply because of removing the desead collateral veins it is possible to fully recover its function.
If the saphenous vein is not recoverable, the technique used for its removal is always geared to the sweetness and mini-invasivity, so as not to significantly reduce the advantages of this method.
PRINCIPLES OF A.S.V.A.L. METHOD
The diseased veins are removed with “sweetness”:
– Varicose veins are removed through micro-incisions made with a needle (less than two millimeters)
– Each surgical act is done with great caution, pulling gently on the veins, no bleeding, no bruising and no pain.
The removal is selective, targeted, depending on each case:
– Only diseased and unrecoverable veins are removed. The ASVAL method tends to preserve the saphenous vein as much as possible
– The preservation of healthy veins can better respect the circulatory physiology.
The anesthesia is performed with diluted local anesthetic:
– Because the ASVAL method is more gentle and circumscribed, the anesthesia may be lighter but effective, risk-free
– A local anesthetic to limited segments of vein to be removed is sufficient.
THEREFORE:
Minimum hematoma = minimum pain
The ASVAL method combined with local anesthesia, micro-incisions and respect of healthy veins leads to few haematomas, and consequently to little postoperative pain.
No hospitalization = ambulatory surgery
The discharge is made two hours after the end of the intervention, “by walking”.
No stitches on the skin = steril strips
The micro-incisions are covered with steril strips (small adhesive patches), waterproof, which can allow you to take a shower within 48 hours. No medication is usually required for the incisions on the lower limbs.
Micro-incisions = aesthetic result + + +
The micro-incisions and the sensitivity of the method ASVAL provide a very satisfactory cosmetic result.
Stockings: only for 2-8 days
. Once again, the low degree of trauma of the method allows to wear stockings ( often uncomfortable ) only for a very short period.
Fast Recovery = from 2 to 8 days on average
. The lack of bruising, pain and disability allow a rapid return to work and normal activities.
| Traditional surgery | ASVAL method | |
| Surgical procedure | Systematic ablation of the great saphenousvein | Personalized: respect of the recoverable veins |
| Anaesthesia | General orlocoregional ( epidural or spinal ) anaesthesia | Local anaesthesia |
| Hospitalization | 2 to 3 days | No |
| Postoperative haematomas | Important | Tiny |
| Postoperative comfort | Stitches on each incision – Daily dressings -No shower until the ablation of stitches | No stitches = cutaneous strips – No dressings on the legs – Daily shower as from the 2nd postoperative day |
| Stockings | 3-4 weeks | 2-8 days |
| Out of work time | 3 weeks | 2-8 days |