St. Thomas Institute of Research on Venous Diseases
About the Institute
This is an exclusive Centre for offering modern treatment for diseases associated with the venous system. This is working in collaboration with the Rajiv Gandhi Centre for Biotechnology (RGCB), Thiruvananthapuram, Kerala, the prestigious biotechnology institute of India (Science & Technology Dept, Govt. of India). We are engaged in advanced research and studies at par with international standards to impart better knowledge in the field of Phlebology (Venous Studies), whereby we can offer better services to the suffering fellowmen by improving the quality of life.
About the treatment
There are various techniques followed for the treatment of varicose veins. The commonly used procedures are grouped into two. The first one is the commonly practised open surgical techniques like Trendelenburg’s operation combined with vein stripping or multiple ligation/excision of superficial veins. The second group is generally called “minimally invasive procedures” as they help to avoid very long hospital stay and the unsightly scars. Patients can have normal activities and go to work early. It helps to reduce the pain of surgery, cost of surgery and loss of family income.
Unlike what is being practiced throughout the world for the procedure of Microfoam Sclerotherapy (MFST), we differ in the principle of the technique of the procedure and made it more physiological by making a little modification to benefit the patient with better outcome and speedy recovery. Sclerotherapy is generally used as the procedure for ablation of veins by using a chemical solution. The chemical solution is mixed with water and air in a certain proportion and agitated in syringes to make microfoam. The microfoam thus produced is administered into the veins at selected points. The inner lining of the veins due to chemical burn gets sclerosed and scarred with fibrosis and the vein lumen gets obliterated. In our procedure selection of the site and size of the veins are totally different from the conventional or classical sclerotherapeutic technique and hence called Modified Microfoam Sclerotherapy or more precisely termed a “Chemical Bombing”.
Examinations before the procedure
A very detailed physical examination and investigations relating to all systems of the body are done before subjecting the patient for the procedure, irrespective of whether it is already existing, co-existing or unknown to the patient. If we think the patient requires consultation with other specialities or further detailed investigations patient has to undergo such examinations. The procedure is done only after confirming the physical fitness.
Working days and time
Out Patient Department:
Tuesday & Fridays only (except public holidays and Bandh/Hartal days)
Patients should report before 8 AM (whether for new consultation or review).
Theater days:
Mondays & Thursdays
Prerequisites on arrival for the procedure:
1. Please do not get carried away with the notion that just coming to hospital you can immediately consult the doctor and finish off the procedure on the same day and return home.
2. There should be one responsible person along with the patient.
3. The cost of treatment depends on the stage of the disease. Detailed investigations, consultations, room rent etc. may enhance the total cost of treatment. This is the least expensive and most effective mode of treatment, when compared to any other treatment modalities.
4. Those eligible for reimbursement of treatment expenses by different schemes should report the hospital sufficiently in advance. Late reporting may create inconveniences.
5. In the out-patient department, patients are categorized into two groups; one group of new patients and the other of review patients. They will be seen in two different sessions strictly according to the priority of token number.
6. In case you so desire to consult the Chief Consultant, the patients as well as the accompanying persons may have to be patient enough to wait for your turn. If you are in a hurry, you have to get satisfied by consultation with Junior Consultants.
7. Please find time to read and understand all the details given in the instruction leaflets issued at different levels of treatment. This will help you for a speedy recovery and wellness.
8. In order to help you understand all about your disease, the procedure and post-procedure care, there is a detailed video session in which every patient (and relatives) should partake. This is a disease awareness class which will not only help you but also the community as well.
Before the procedure
Though the treatment is usually a day care procedure, the patient is instructed to get admitted at least one day earlier. This helps to complete all the tests prior to procedure. Also it would help us to plan our work. In very advanced stages of the disease, especially with swelling of the leg and infections, patient would be advised admission in hospital a few days earlier for proper evaluation and preparation.
After the procedure
Can the patient go home on the same day?
Yes. Most of the patients can return home on the same day. But in rare cases with advanced stage of the disease, patients would be required to stay in hospital for one or more days.
Please do remember
i. Effect of Sclerotherapy: The literal meaning of the word ‘Sclerosis’ is hardening. In Sclerotherapy, the surgeon is producing a chemical burn on the inner lining of the vein to produce subsequent scarring inside the vein. The chemical burn produces swelling of the vein wall and this is followed by slow fibrosis and obliteration of vein lumen. Hence the vein becomes swollen and hard after the procedure. Over a period of time, it may be weeks or months, the vein disappears depending on its size; the smaller ones first and the larger ones last.
ii. Protect the leg from swelling: All the complications of the disease begin with the appearance of swelling of the lower part of the leg & foot. The swelling finally proceeds to ulcerations, stage by stage. So please help the leg in the process of recovery by keeping it elevated to facilitate gravitational drainage by keeping the heel elevated above the level of umbilicus with the knee fully extended all the time while you are awake and not while sleeping. You may keep your leg as you like, for your comfort, while you sleep at night to have a nice sleep. It is sure that no human being will prefer to keep the legs down during sleeping at night.
iii. Periodic Review: Just by one sitting it may not be sometimes possible to clear off all the varicose veins. It may require multiple sittings. There is a limit for the quantity of Sclerosant that can be administered. Sometimes the veins can regenerate just like weeds. This has to be periodically inspected and if found necessary, weeded out by repeated procedures. So the follow up after the procedure is very important. A review schedule for a period of six years is worked out and given to all the patients at the time of discharge. This will help to bring the disease under complete control.
iv. At the time of Review in the OP: Don’t forget to get the Out Patient File (OP Record) before reporting for review by the surgeons. It is imperative.
Please feel free to contact the hospital or the doctors in case of any absolute necessity or any further clarifications. But please never misuse your phone for silly reasons.
