Ultrasound guided sclerotherapy is a form of treatment that is being increasingly used, especially in the
outpatients' department, by phlebologists. Compared with surgery on varicose veins, sclerotherapy is highly
beneficial for the patient in that it is a much less invasive procedure.
The ultrasound guided sclerotherapy method was made public for the first at the conference of the
International Union of Phlebology (IUP) in Strasbourg in 1989 [1] and has been described in many publis-
hed studies as an effective treatment method that has few adverse effects [2,3].
3.2 Learning to carry out sclerotherapy on the simulator
In order to learn how to carry out ultrasound guided sclerotherapy and to gain practical experience, dex-
terity and confidence, it is necessary for the student to get the opportunity to carry out a sufficiently large
number of treatments during training.
During initial training, in the interest of patient safety, the necessary techniques and skills can be acquired
first of all using a simulator. The simulator must therefore realistically reproduce the circumstances of clini-
cal practice, including anatomy, and the feel and echogenicity of the human skin tissue.
Another advantage of the simulator is that it offers the opportunity to continually repeat the procedure,
which in turn increases patient safety. A simulator to learn how to carry out ultrasound guided sclerothera-
py is seen by experienced practicing phlebologists as a useful pedagogical tool [4].
3.3 What is needed for simulation?
To simulate ultrasound guided sclerotherapy, you need, in addition to the prepared simulator shown here:
• An ultrasound device with a 10-18 MHz probe
• Materials to prepare and carry out sclerotherapy (syringe, cannula and medication or a suitable
substitute)
The innovative material that the simulator is made of is unusually realistic thanks to:
• The consistency of the material
• The material's resistance
• The echogenicity of the material
Consistency of the material
The consistency of the material while positioning the probe and injecting the material guided by ultra-
sound, corresponds to the consistency of human soft tissue, so for the student, it feels like carrying out a
real procedure on a patient.
The material's resistance
The resistance of the material used for ultrasound guided puncture of the vessel replicates the features of
real human tissue perfectly.
Echogenicity of the material
The ultrasound characteristics of the material on the simulator are very similar to those of a real life situa-
tion on a patient.
3.4 Carrying out the simulation step by step
Carrying out the simulation of ultrasound guided sclerotherapy
• Connect the accessories with the simulator as described below: The "blood" should flow – just like in the
veins – in a distal to proximal direction, so the following position should be adopted by the doctor/user:
For right-handed people:
Infusion bottle with the infusion system on the right, and the reservoir on the left (the user is placed in a
dorsal position)
For left-handed people:
Infusion bottle with the infusion system on the left, and the reservoir on the right (the user is placed in a
ventral position)
Fig. 1
Simulator for ultrasound guided sclerotherapy
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