Minimally invasive laser therapy has many advantages and brings beautiful cosmetic results

Dr. med. Maria Studer is a specialist in surgery and opened her own practice in Berne, Switzerland, in October 2018 after many years of professional experience. During her professional career, Dr. Studer has increasingly specialised in the treatment of venous diseases. Dr. Studer completed her further training in endovenous thermal ablation of truncal veins with Prof. Dr. med. Enzler in Feldmeilen/ Zurich with the ELVeS^® Radial^® laser therapy from biolitec^®.

• Is there a possibility for patients themselves to recognize whether they have varicose veins and whether these need to be treated, so to speak a "vein check"?

Swollen legs and a feeling of heaviness after standing or sitting for a long time can be the first signs of venous disease. Often, superficial side branches or large spider veins can also be seen directly under the skin. These external varicose veins can lead to itching and stasis eczema (dry, scaly skin). Typical skin changes with many spider veins on the inside of the foot (corona phlebectatica paraplantaris) and brown discolorations on the inside of the lower leg are found in advanced venous diseases. A non-healing wound (ulcus cruris) usually on the inner ankle describes the final stage of the disease. In the case of one or more of these complaints, the general practitioner should be informed first and then referred to a specialist if necessary.

• Can something be done to prevent varicose veins from occurring in the first place?

The cause of varicose veins is usually genetic and can therefore only be influenced to a limited extent. Pregnancy, overweight and increasing age increase the risk of getting varicose veins.

In principle, however, one can say: "Running and lying is good, sitting and standing is bad". Integrate running into your everyday life. For example, take the stairs instead of the lift, walk short distances instead of driving. Exercise has an overall positive effect on your well-being, not just on venous diseases.

• Many people see varicose veins only as a cosmetic problem. Can varicose veins also become dangerous? - When should varicose veins be treated?

Spider veins (small superficial veins in the skin) are cosmetically disturbing and usually have no disease value. However, varicose veins can lead to skin changes up to the "open leg" due to chronic congestion over many years. In the long term, I therefore always recommend a specialist medical examination. Depending on the severity of the disease, it can then be discussed together whether and what kind of therapy is appropriate for the patient.

• They mainly use ELVeS^® Radial^® laser therapy. Can this method be applied to every patient?

ELVeS^® Radial^® laser therapy is suitable for the treatment of truncal veins, which are usually the origin of externally visible varicose veins. These truncal veins run mostly within a fascia (muscle envelope, intrafascial) and have a certain distance to the skin. Side branches that are close to the skin should not be treated with the laser, as the development of heat can damage the skin.

In my patient I often use a combination of several procedures: The truncal veins or recurrent veins running in a straight line are closed with the ELVeS^® Radial^® laser therapy, the winding lower parts are sclerosed with foam sclerosis and superficial side branches can be removed by phlebectomy (hook method).

All procedures are performed under local anesthesia in the same session.

• What advantages do you see in laser therapy?

The advantages of laser therapy over open surgery (stripping) are manifold. As this is a minimally invasive procedure, no large incisions are necessary and the result is a very beautiful cosmetic result. The treatment is painless and can be performed on an outpatient basis in the practice. Due to the short recovery time, a quick return to normal everyday life is possible.

With the double ring technology (ELVeS^® Radial^® 2ring), the defective vein section can be treated precisely. By varying the energy, even larger veins can be closed perfectly.

Blood-thinning drugs do not have to be stopped for laser therapy, as only a puncture of the veins is necessary.

• Does the ELVeS^® Radial^® laser therapy treatment take place directly in your practice?

Yes, all steps of the treatment, from the clarification over the laser treatment itself up to the follow-up (1 week after the treatment) take place in my practice. We will be happy to arrange an appointment with the patient. The treatment usually lasts 1-2 hours, depending on whether one or both legs are being treated. To monitor the long-term healing process, we arrange a final appointment after approx. 3-6 months.

• Does a treatment have to be paid for privately or does the basic health insurance cover it?

The preliminary and follow-up examinations using ultrasound and laser therapy (also in combination with sclerotherapy and phlebectomies of varicose veins) are covered by the basic insurance of the health insurance company in Switzerland. Patients only pay the usual deductible, whereby the amount of your deductible must be taken into account.Laser treatment of venous diseases (endovenous thermoablation) has only been covered by the health insurance since 01.01.2016. This shows the clear revaluation of the procedure by the legislator and adaptation to the procedure in our neighbouring countries. If the health insurance company nevertheless demands a cost credit language (notification for cost assumption by the health insurance company), we will gladly request this for our patients.

Further information can be found at www.venenpraxis-bern.ch.