Vascular surgery
repeat surgery. Prof. Jaffer uses Dopplex ultrasound to ensure
the technical soundness of his procedures. The latest technology provides both an audible waveform signal, as well as digital waveform images, to provide extra diagnostic information. Waveforms can also be saved and exported to be included in the patient record. The system can be used for pre-, peri- and post-operative assessments simply by changing the probe being used. Both clinicians and patients then benefit from being able to accurately track outcomes with consistency. “There is a concept of non-destructive testing during surgery,” Prof. Jaffer comments. “You need to know what’s going on; it’s not good enough to have performed the procedure - you need verification that everything is ok. In healthcare, we have developed ultrasound to perform this role. The advantage of this handheld Doppler device is that it offers you a test that that reports immediately. You just switch it on and go. There are more complicated tests with bigger ultrasound machines, but they are not as immediate in terms of feedback.” According to Prof. Jaffer, “The technology
gives rapid results, with very fast feedback, but it also gives a visual waveform, which gives more certainty in terms of what you are looking at. In the past, Doppler machines were just audible, but there’s a lot of guesswork around listening and characterising the audible Doppler signal… We have published research that shows that a visual signal is much better than just an audible signal.”3
During a common femoral endarterectomy, the Dopplex surgical probe detects triphasic signals, indicating healthy blood flow patterns. These signals are crucial for verifying that both inflow and outflow are adequate. “If it is triphasic we are extremely pleased; if it isn’t triphasic, we want to find out why and
single-use intraoperative probes into his practice, which is not only important from an infection prevention perspective, but also avoids reliability issues associated with wear and tear caused by repeated reprocessing: “Poor care costs a lot more than good care, so it is important to deliver good care as many times as possible – first time. If that requires a single-use piece of equipment and you know it is going to work, that pays dividends in the medium to long- term,” he concludes.
correct the problem,” says Prof. Jaffer. He points out that Doppler monitoring
not only enhances safety but contributes to efficiencies in the theatre: “If you are sure that the bypass or patch plasty is working well, you can close up quicker and move on to the next case. Feeling confident rather than waiting another 20 minutes to see if it’s still ok, means there is the potential to reduce waiting times,” he explains. Prof. Jaffer reveals that he has adopted
An essential part of ‘standard practice’ Professor David Bosanquet, a Consultant Vascular Surgeon at the South East Wales Vascular Network, University Hospital of Wales, also considers the Doppler probe an essential tool in vascular surgery. Prof. Bosanquet specialises in a wide range of arterial operations, including bypasses, revascularisation of legs, open and endovascular aortic surgery, carotid surgery, and amputations. “A lot of what we do in vascular surgery is about achieving better flow past blockages, through a variety of different ways – it may involve the use of a balloon to pull out a clot, inserting stents or performing a bypass. If you have a small technical issue, the vein or artery isn’t good enough, or if the flow isn’t good enough, it may block off in recovery, the next day, or in a few days’ time,” he explains. “When you have performed a bypass from
the groin artery to the knee artery, and you take off the clamps, you will be able to see pulsation within the vessel, and you will be able to put your finger on it and feel it. While it provides you with some information that pressure is coming down the vessel, you cannot be certain that there’s actual flow. “The kind of pulse you want isn’t necessarily
a really strong one – sometimes this can imply that it is ‘hitting a wall’ – there may be an
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www.clinicalservicesjournal.com I February 2026
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