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 an in-depth examination and draw conclusions about which treatment tactics are best to take: conservative or surgical treatment. If for some reason the drugs could not have the desired effect on the patient's blood vessels, then doctors prescribe surgery, which can now definitely help.

Indications and whether surgery is necessary at all

Surgery to remove varicose veins 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 heaviness in the legs or elsewhere, depending on the location 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 (eg thrombophlebitis, trophic ulcer or pulmonary embolism).

In a direct conversation with the doctor, he will be able to determine whether the operation is worth doing, as well as talk about what types of surgery exist in general.

Contraindications for surgical treatment of varicose veins

Despite the strong indications, there are many cases in which surgery to remove varicose veins in the legs can not be performed. For example, if the patient has the last stages of varicose veins, then surgical treatment will not always be possible. In such cases, 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, such as eczema, pyoderma, dermatitis, etc.
• severe 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 erasing atherosclerosis;
• old age;
• period of pregnancy.

Patients should remember that in case of taking medication for other diseases, the attending physician should be notified.

Sclerotherapy technique

Sclerotherapy is a procedure whose principle is to inject a special substance into the affected vessel, causing further contraction and overgrowth 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 one stage of sclerotherapy, the specialist makes two to ten such 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 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 the process involves small vessels that lie more superficially. In such cases, the required amount of sclerosant is minimal.
2. Echosclerotic. It is performed on deeper veins using duplex scanning to determine the exact location of the deep varicose veins.

Laser coagulation

Laser surgery for varicose veins is 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 must tell 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 apparatus and acts on the walls of the dilated vessels. Under its action, the vessel coagulates and closes.

This technique will be justified if the patient has varicose veins in the legs or groin. In addition, laser coagulation will work more effectively on large vessels, so 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 of the legs, requiring a large incision and direct surgical access.

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 accesses the indicated vessel at the point where the saphenous vein joins the femoral vein. The surgeon then performs a dressing with special threads.

In women, pelvic vein surgery can be performed. In this case, access and ligation of the ovarian vein is performed.

Removal of dilated vessels

The most common and proven method of surgery is phlebectomy. Doctors perform it almost every day and it is more accessible 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. After opening access to the area with varicose veins, the surgeon ligates the vessel, crosses it and removes it.

Miniphlebectomy is a subtype of this intervention. It differs from conventional phlebectomy in that the surgeon needs punctures rather than incisions to access the vessel. This operation is effective for affecting small superficial vessels. Its main advantage is that it does not leave behind any traces and cosmetic defects.

Stripping

Stripping is one of the subtypes of phlebectomy, during 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 subcutaneous vein and makes access to the vessel. The doctor then makes another incision - in the middle or lower leg.

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

There are several types of manipulation in stripping:

1. Short stripping. The whole vessel is not eliminated, but only a certain area, which is the subject of the varicose process.
2. Total. Such surgery for varicose veins of the lower extremities allows you to get rid of a large area of diseased vessels and avoid further recurrences.

Consequences of surgery and rehabilitation

In varicose veins, surgery can have the opposite effect and cause various complications. They must be divided according to the type of intervention carried out:

1. After sclerotherapy, the patient may experience itching, burning, discolouration of the skin and swelling at the injection site. There may be a rise in body temperature and general weakness. Following the rules of the postoperative period, the symptoms disappear after a few days.
2. After undergoing laser coagulation, the patient may experience tension in the thigh area, slight bleeding and fever. With proper treatment, the symptoms disappear within a week.
3. Vein ligation can be complicated by trauma and bleeding during the operation itself.
4. Phlebectomy and stripping can damage nerves in the skin. This may be accompanied by loss of sensation, tingling in the legs, pain at the incision site.

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

To avoid the above complications and minimize your rehabilitation period, you should adhere to the recommendations for the care of your health and blood vessels in the postoperative period.

Following the rules of the postoperative period, the symptoms disappear after a few days.

There are a number of pros and cons that experts recommend to adhere to:

• Immediately after the operation and in the first week after it is necessary to wear special compression underwear - it can be in the form of socks, tights, socks, and for this 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 can not perform any cosmetic procedures and apply various cosmetics.
• Avoid strenuous exercise. If before the treatment the patient has been engaged in some kind of sport (especially heavy), after the operation the heavy loads should be forgotten 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 preventive exercises lasting no more than 15-30 minutes.
• Follow the phlebologist's prescriptions for medication - take regular prophylactic anticoagulants, phlebotonics, nonsteroidal anti-inflammatory drugs, thrombolytics and other drugs.

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