Surgery to remove varicose veins on the legs

When faced with such a problem as varicose veins of the lower extremities, the patient should not hesitate to consult a doctor and start treatment. An experienced specialist will conduct a thorough examination and draw conclusions about the best therapeutic tactics to adopt: conservative or surgical treatment. If for some reason the drugs could not have the desired effect on the patient's blood vessels, doctors prescribe surgery, which can already help unconditionally.

Indications and need for surgery

Surgery to remove varicose veins is a radical approach to treating pathological vessels, so the indications will be appropriate.

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The operation will be justified in the following cases:

• total varicose veins of the lower extremities, which is noticeable with the naked eye;
• severe and constant swelling of the legs, discomfort, pain and a feeling of heaviness in the legs or in other places, depends on the localization of the pathological process;
• a direct threat that existing varicose veins in a certain part of the body will be complicated by a more dangerous disease (for example, thrombophlebitis, trophic ulcer or pulmonary embolism).

In a direct conversation with the doctor, he will be able to determine whether it is worth having the operation and also talk about the types of surgeries that are generally available.

Contraindications to surgical treatment of varicose veins

Despite the strong indications, there are many cases in which surgery to remove varicose veins on the legs cannot be performed. For example, if a patient has the late stages of varicose veins, surgical treatment may not always be possible. In such cases, the doctors focus on the drugs, but they cannot help enough.

A number of other mandatory contraindications:

• the presence of skin diseases at the site of the affected vein, for example, eczema, pyoderma, dermatitis, etc.
• serious diseases of the cardiovascular system - hypertension, coronary artery disease, heart failure;
• acute inflammatory process inside the vessel (phlebitis);
• previously transferred thrombosis or pulmonary embolism;
• active process of erasure of atherosclerosis;
• advanced age;
• period of pregnancy.

Patients should remember that when taking medication for other diseases, the attending physician should be informed.

Sclerotherapy technique

Sclerotherapy is a procedure in which the principle is to inject a special substance into the affected vessel, causing further contraction and proliferation of the vessel. The main advantage of this method is that the procedure does not require any incisions or surgical access.

The essence of the procedure is as follows: with the help of a syringe, the doctor injects a sclerosing substance into the pathological vessel. During a stage of sclerotherapy, a specialist performs two to ten of these injections. The effect does not appear at the same time - it usually takes 2-8 weeks and several sessions of such a procedure. Under the action of the sclerosant, the vein gradually narrows, then invades and disappears.

There are two types of manipulation:

1. Microsclerosis. It is justified in the early stages of varicose veins, when small, more superficial vessels are involved in the process. In such cases, the amount of sclerosant needed is minimal.
2. Echosclerosing. It is performed on deeper veins using a duplex scan to determine the location of deep varicose veins as precisely as possible.

Laser coagulation

By far the most popular is laser surgery for varicose veins. This is due to the fact that the procedure itself is performed under local anesthesia, does not require large incisions and tissue trauma and has an immediate effect.

The vascular surgeon should explain in detail how the operation is performed, but, in general, its essence lies in the introduction of a special laser light guide into the diseased vessel. A laser beam, which has its own wavelength, passes through this device and acts on the walls of varicose vessels. Under its action, the vessel coagulates and becomes blocked.

This technique will be justified if the patient has varicose veins in the leg or groin. In addition, laser coagulation will act more effectively on the large vessels, which is why the use of this technique in the event of damage to small veins is unjustified.

Ligation of the veins

Vascular ligation is a more radical operation for varicose veins in the legs, requiring a large incision and direct surgical access.

The operation is performed more often on the legs than on the vessels of the pelvic region. The saphenous vein ligation technique will be effective. The vascular surgeon accesses the indicated vessel where the saphenous vein meets the femoral vein. Then the surgeon makes a bandage with special threads.

In women, pelvic vein surgery may be performed. In this case, the ovarian vein is accessed and ligated.

Removal of dilated vessels

The most common and proven surgical method is phlebectomy. Doctors do it almost every day, and it's more affordable than laser coagulation or sclerotherapy. Such an operation for varicose veins is performed under general anesthesia or epidural anesthesia.

To remove the dilated vessel, the surgeon needs an incision only 0. 5 to 1 cm long. After opening access to the area of varicose veins, the surgeon ligates the vessel, passes through it, and removes it.

As a subspecies of this intervention, miniflebectomy is distinguished. It differs from conventional phlebectomy in that the surgeon needs punctures rather than incisions to access the vessel. This operation is effective in affecting small superficial vessels. Its main plus is that it does not leave traces and cosmetic defects.

Stripping

Stripping is one of the subtypes of phlebectomy, in which a special probe is used to remove a vein. As with the simple removal of varicose veins, the surgeon makes an incision in the saphenous vein and accesses the vessel. Then the doctor makes another incision - in the middle or the bottom of the leg.

Through the upper access into the great saphenous vein, a special probe is introduced - an extraction probe. The surgeon pre-strips the mouth of adjacent veins. The probe is passed the entire length of the vessel to the lower incision, after which it is used to remove the vein.

In pickling, there are also several types of handling:

1. Short stripping. It is not the whole vessel that is eliminated, but only a certain area subjected to the varicose process.
2. Total. Such an operation for varicose veins of the lower extremities allows you to get rid of a large area of diseased vessels and prevent further relapses.

Consequences of surgery and rehabilitation

Having varicose veins, the operation can have the opposite effect and lead to various complications. They must be separated by the type of intervention carried out:

1. After sclerotherapy, the patient may experience itching, burning, discoloration of the skin, and the appearance of edema at the injection site. An increase in body temperature and the appearance of general weakness are possible. Subject to the rules of the postoperative period, the symptoms disappear within a few days.
2. After undergoing laser coagulation, the patient may experience a feeling of tension in the thigh area, minor bleeding, and an increase in body temperature. With proper treatment, symptoms go away within a week.
3. Venous ligation can be complicated by trauma and bleeding during the operation itself.
4. Phlebectomy and stripping can damage the nerves in the skin. This can be accompanied by loss of feeling, numbness in the legs, pain at the incision sites.

For all methods of surgical treatment there is a common complication - thrombosis. This is a dangerous process, but the risk of it happening as a result of an operation is very low.

In order to avoid the aforementioned complications and to shorten your rehabilitation period as much as possible, you must adhere to the recommendations for the management of your health and blood vessels in the postoperative period.

Subject to the rules of the postoperative period, the symptoms disappear within a few days.

There are a number of advantages and disadvantages that experts recommend to adhere to:

• Immediately after the end of the operation and during the first week afterwards, it is necessary to wear special compression underwear - this can be stockings, tights, socks and, for this purpose, you can also use ordinary elastic bandage.
• Eliminate bad habits - alcohol consumption, smoking, drug use.
• Avoid baths and saunas, as well as baths that are too hot.
• In the place where the operation was performed, you can not perform any cosmetic procedures and apply various cosmetic products.
• Avoid strenuous physical activity. In the event that before the treatment the patient practiced any type of sport (particularly difficult), then after the operation heavy loads should be forgotten for at least 5-8 weeks. In the future, you should consult your doctor if it is possible to continue to practice intensive sport.
• Do daily prophylactic exercises for a maximum of 15 to 30 minutes.
• Observe the phlebologist's prescriptions for taking medication - regularly do prophylactic anticoagulants, phlebotonics, nonsteroidal anti-inflammatory drugs, thrombolytics and other drugs.

In general, all of these operations have good reviews from doctors and patients. Which treatment approach is suitable for a particular patient should be decided only with the attending physician.