At the end of the past year, one of the 5 machines existing in the world today arrived in Italy directly from Wong Wah Hospital in Hong Kong and promises to revolutionize the treatment of chronic venous disease for which 5 million operations are performed every year.
This is Sonovein®, the first HIFU (High Intensity Focussed Ultrasound) robotic treatment, i.e. high-intensity focused ultrasound, developed by Theraclion, a Chinese company specializing in the production of high-precision surgical robots.
To welcome Sonovein® in our country was the Vice President of the Italian Phlebological Association Professor Paolo Casoni of Parma who allocated him to the Vein Clinic Ippocrate Parma (www.ippocrateparma.it) of which he is also Scientific Director and where they have already been the first 28 Italian cases successfully carried out; currently the center team is proceeding with the treatment of 4-5 cases per week.
Sonovein® saves time and treatment costs as it does not require a dedicated surgical room, assistance staff and conventional surgical preparation for the patient who can be discharged within the day without incisions or scars, having experienced no pain and without having to then wear annoying containment bandages for at least two weeks.
While the robot “operates” under the doctor’s control, the patient does not need anesthesia and does not run the risk of postoperative infections or bleeding. Using a special articulated head, it follows the course of the vein to be treated point by point, sending the ultrasonic pulses transcutaneously that hit the target with absolute precision. The treatment is always personalized with the possibility of acting even on vessels that are difficult to access with conventional therapies, also solving recanalizations or neovascularizations deriving from previous interventions that can be easily resolved without incisions. And above all, the patient is discharged within the day with the prospect of not presenting the relapses that often instead weigh on the usual treatment methods such as saphenectomy stripping or therapy with sclerosing venous shrinking drugs and which also occur with the most conservative techniques with the which, trying to maintain the drainage function of the connection between the anterior and posterior lodges of the leg, the saphenous vein is spared using the intravenous laser, radio frequency or cyanoacrylate glues.
The huge mass of first operations and re-operations on frequent relapses prompted Chinese surgeons to opt for the new method.
“In Italy, the condition affects about 19 million people – explains Professor Casoni – but despite the high incidence at least 1 patient out of 3 neglects the symptoms, underestimating the risks that in the most serious cases go well beyond pain and ‘blemish from sloping edema and superficial venous branches, leading to the formation of dangerous thrombi due to chronic inflammation of the vascular endothelium ”.
In the general Italian population, if we consider the saphenous circulation and its collaterals, the disease has a frequency of 15-30%, which becomes 35% including only aesthetic varicosities.
This morbid condition absorbs a share equal to 1-3% of the health resources of Western countries where a prevalence of 25-80% is calculated mainly linked to incorrect thrombophilic lifestyles such as excessive sedentary lifestyle, overeating with overweight and insufficient motor activity. To this are added genetic or genetic predisposing factors; those who suffer from varicose veins are mostly women: after the age of 50 two thirds of patients are in fact female. In the so-called Vein Clinics, the study of these / and patients provides for an adequate assessment of coagulability both by genetics and by saliva on the basis of which the team decides on the best treatment to be adopted and also to be agreed with the patient, to whom they can preventive advice be given regarding diet and lifestyle changes which, as indicated, are important risk factors in the Western population.
Curated by Cesare Peccarisi – FarmInforma
