Walk-in walk-out surgery under local anaesthetic for varicose veins has been our standard treatment for 12 years at The Whiteley Clinic. Walk-in walk-out surgery under local anaesthetic is also called “ambulatory surgery”.
This 59-year-old lady is a typical example of The Whiteley Protocol® in action.
For many years, this lady had varicose veins of her right leg that were steadily getting worse. Initially, she was told they were not worth treating and were “only cosmetic”.
However, we now know that varicose veins will deteriorate if left untreated, faster in some people than others.
In this particular patient, she started to notice that her right ankle was starting to develop eczema and the skin was becoming discoloured. These skin changes are medically called CEAP C4 changes. Search changes have been approved by the National Institute for Health and Care Excellence (NICE) as requiring surgery.
Therefore she underwent treatment as per The Whiteley Protocol.
The Whiteley Protocol® starts with a full history and clinical examination, followed by a full venous duplex ultrasound scan of both legs by a The Whiteley Clinic trained clinical vascular scientist.
In this case, the patient was found to have a massive and incompetent great saphenous vein as well as two incompetent perforating veins feeding her varicose veins and causing the skin damage.
She underwent endovenous laser ablation (EVLA) of the great saphenous vein, TRLOP closure of the perforators and ambulatory phlebectomies all at one operation under local anaesthetic. As a walk-in walk-out patient, she was only in the clinic for 2 and 1/2 hours, of which just over one hour was the operation.
She wore a support stocking for three days but was back to normal walking immediately and driving and her normal work the day following surgery.
With such big varicose veins, she did have some tender lumps for the first week or two after the procedure, but these did not hurt her enough to even need any painkillers.
Over the four weeks recovery so far, have venous eczema has disappeared and the skin damage has started improving already.
She may need some foam sclerotherapy as an adjunct to her treatment, but this will be decided if she has any symptomatic veins left in a few weeks time.
The patient is already very happy with her treatment, particularly the incredibly quick recovery, the disappearance of her varicose veins and the big improvement in venous eczema.
At The Whiteley Clinic, it has been standard to perform walk-in walk-out local anaesthetic surgery for varicose veins on all patients for the last 12 years. By keeping patients mobile and only using local anaesthetic, deep vein thrombosis and nerve damage have virtually disappeared as complications of varicose vein surgery.