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When I was a child my grandfather told me a story from his childhood. When he was eight years old he had an abscessed tooth and it needed to be pulled. A long and sturdy thread was tied to the bad tooth and the other end of it was fastened to a doorknob. His parents held him tight and a third person pulled open the door as hard as he could. The tooth was pulled out, my grandfather fainted for few minutes and then it was all over.
When my son had a tooth problem I jokingly offered the same treatment.
"Thanks but no thanks," said my wife; she was taking him to the dentist.
I often wonder why, at the dawn of the 21st century, most of the surgeons are treating varicose veins almost the same way it was practiced a hundred years ago -- with Stripping and Ligation.
Certainly, in the course of the last century we have witnessed remarkable improvements in anesthesia, surgical techniques, prevention of infection and improving modalities such as surgical instruments, suture material, etc. Nevertheless, varicose vein patients are still admitted to the hospital and subjected to general anesthesia. Several incisions are made on the groin, thigh and leg in order to strip the main trunks of superficial veins, called the saphenous vein. Bulging varicose veins are also removed through multiple incisions.
In addition to prolonged recovery, several weeks out of work, considerable pain and discomfort, patients are left with permanent, unsightly scars, as you can see in the picture.
One time I explained to a patient that I could treat her varicose veins in my office, under local anesthesia and possibly without making a single incision. On the day of surgery she could simply walk in and walk out.
She paused, gave me a look and said "magic?"
I laughed.
In fact, recent marvelous technological advancements as applied to surgical techniques have not been any less than magical.
We never believed that a gall bladder could be removed without opening the abdomen. But now it can and it only takes four little holes!
Who could imagine that a fetus with a heart defect could be operated upon while still in her mother's womb?
And yes, we can treat varicose veins with the use of marvelous laser machines, and under local anesthesia without making incisions and with minimal discomfort for the patient.
To strip the veins, under general anesthesia, by placing a wire in the vein and ripping the vein off the leg is no less antiquated as the way they pulled my grandfather's tooth.
It is time that we learn some lessons from history. |
