Surgery to remove varicose veins in the legs

Faced with such a problem as varicose veins of the lower extremities, the patient should not hesitate to visit a doctor and start treatment. An experienced specialist will conduct a thorough examination and draw conclusions about which therapeutic tactics are best to take: conservative or surgical treatment. If for some reason the medication could not have the desired effect on the patient’s blood vessels, then doctors prescribe surgical intervention that can already help unconditionally.

Indications and whether surgery is needed at all

Varicose vein removal surgery is a radical approach to the treatment of pathological vessels, so the indications for it will be appropriate.

The operation will be justified in the following cases:

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

In a direct conversation with the doctor, they will be able to determine if the operation is worth doing, and they will also discuss what types of surgical interventions exist at all.

Contraindications for surgical treatment of varicose veins

Despite strong indications, there are many cases in which surgery to remove varicose veins in the legs cannot be reported. For example, if a patient has the last stage of varicose veins, then surgical treatment will not always be possible. In such cases, doctors focus on medications, 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.
• severe diseases of the cardiovascular system - hypertension, coronary artery disease, heart failure;
• acute inflammatory process inside the vessel (phlebitis);
• previously transmitted thrombosis or pulmonary embolism;
• active process of atherosclerosis removal;
• older age;
• period of pregnancy.

Patients should keep in mind that in case of taking medication for other diseases, a doctor must be informed.

Sclerotherapy technique

Sclerotherapy is a procedure whose principle is to inject a special substance into the affected vessel, causing further constriction and healing of the vessel. The main advantage of this method is that the procedure does not require any incisions or surgical approach.

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

There are two types of manipulation:

1. Microsclerosis. It is justified in the initial stages of varicose veins, when small vessels that lie more superficially are involved in the process. In such cases, the required amount of sclerosant is minimal.
2. Echosclerosis. It is performed on deeper veins using duplex scanning in order to most accurately determine the localization of deep varicose veins.

Laser coagulation

Laser varicose vein surgery is by far the most popular. 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 that has its own wavelength passes through this apparatus and acts on the walls of the varicose veins. Under its action, the vessel coagulates and clogs.

This technique will be justified if the patient has varicose veins in the area of the legs or groin. Moreover, laser coagulation will work more effectively on large vessels, which is why the use of this technique in case of damage to small veins is unjustified.

Vein ligation

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

The operation is performed on the legs more often than on the vessels in the pelvic area. The saphenous vein ligation technique will be effective. The vascular surgeon approaches the indicated vessel at the site where the saphenous vein joins the femoral vein. Next, the surgeon performs the bandages with special threads.

In women, pelvic vein surgery may be reported. In this case, the ovarian connection is approached and ligated.

Removal of varicose veins

The most common and proven method of surgery is phlebectomy. Doctors perform it almost daily, and it is more affordable than laser coagulation or sclerotherapy. Such surgery for varicose veins is performed under general anesthesia or with epidural anesthesia.

To remove the dilated vessel, the surgeon needs an incision only 0. 5-1 cm long. By opening access to the area with varicose veins, the surgeon ligates the vessel, crosses it and removes it.

Miniphlebectomy is distinguished as a subtype of this intervention. It differs from conventional phlebectomy in that the surgeon needs punctures, not incisions, to access the vessel. This operation is effective for involving small superficial vessels. Its main advantage is that it does not leave traces and cosmetic flaws.

Download

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

Through the upper approach, a special probe is introduced into the great saphenous vein - the extraction probe. The surgeon previously bandages the mouth of the adjacent veins. The probe is passed along the entire vessel to the lower incision, after which it is used to remove the vein.

There are also several types of manipulations in downloading:

1. Short download. Not the entire vessel is removed, but only a specific area that is susceptible to the varicose vein process.
2. Total. Such surgery for varicose veins of the lower extremities allows you to get rid of large areas of diseased blood vessels and avoid further relapses.

Consequences of surgery and rehabilitation

Having varicose veins, surgery can have the opposite effect and cause various complications. They should be separated according to the type of intervention performed:

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. According to the rules of the postoperative period, the symptoms disappear in a few days.
2. After undergoing laser coagulation, the patient may feel a feeling of tension in the thigh area, less bleeding, and a rise in body temperature. With proper treatment, the symptoms disappear within a week.
3. Vein ligation can be complicated by trauma and bleeding during the operation.
4. Phlebectomy and removal can damage the nerves in the skin. This can be accompanied by loss of sensitivity, stiffness of the legs, pain at the incision sites.

For all methods of surgical treatment there is one common complication - thrombosis. This is a dangerous process, but the chance of it happening as a result of any surgery is very small.

To avoid the above-mentioned complications and shorten the rehabilitation period as much as possible, you must follow the recommendations for taking care of your health and blood vessels in the postoperative period.

According to the rules of the postoperative period, the symptoms disappear in a few days.

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

• Immediately after the operation and in the first week after it, it is necessary to wear special compression underwear - it can be in the form of socks, tights, socks, and for that purpose you can use a regular elastic bandage.
• Eliminate bad habits - alcohol consumption, smoking, drug use.
• Avoid baths and saunas, as well as too hot baths.
• At the place where the operation was performed, you cannot perform any cosmetic procedures and apply various cosmetic products.
• Avoid strenuous physical activity. If before the treatment the patient was engaged in any kind of sport (especially heavy), then after the operation one should forget about heavy loads for at least 5-8 weeks. In the future, you should consult your doctor if it is at all possible to continue intense sports.
• Do daily prophylactic exercises for a maximum of 15-30 minutes.
• Adhere to the regulations of phlebologists for taking medication - regularly do prophylactic anticoagulants, phlebotonics, nonsteroidal anti-inflammatory drugs, thrombolytics and other drugs.

In general, all of these surgeries have received good reviews from both doctors and patients. Which treatment approach is appropriate for a particular patient must be decided only by the treating physician.