What types of operations are prescribed for varicose veins?

Conservative treatment methods are effective only in the initial stages of varicose veins.And since the first signs usually remain unattended, the pathology continues to develop, reducing the effectiveness of the drugs used.If symptoms worsen significantly, the only option to remove varicose veins is surgery.A special place is occupied by rehabilitation, which requires patients to comply with medical recommendations.

Indications for surgery

If varicose veins are present, surgical treatment is prescribed in certain cases.

In particular, surgical intervention is indicated for patients with:

• extensive vascular damage, which can be determined by visual examination;
• symptoms in the form of swelling, constant aching pain and a feeling of heaviness;
• significant risk of thrombophlebitis, trophic ulcers.

Varicose veins surgery is appropriate when the use of medications does not bring the desired results.It is important to prevent the disease from developing to the point where surgical treatment is futile.

For some patients, surgery for varicose veins on the legs may be contraindicated.

Contraindications

Surgery at the last stage is often inappropriate; accordingly, varicose veins are treated with various drugs.They help to slightly reduce the severity of the disease, but they cannot completely eliminate it.

Patients suffering from:

• inflammatory skin diseases at the site of development of venous pathology (for example, erysipelas or eczema);
• cardiovascular disorders (coronary artery disease, hypertension, heart failure);
• acute form of phlebitis;
• infectious diseases (surgery is possible after recovery);
• venous thrombosis, pulmonary embolism (history);
• obliterating atherosclerosis of the vessels of the lower extremities.

Surgical treatment to eliminate varicose veins is contraindicated in patients over 70, as well as in pregnant women.

Preparing for surgery

A consultation with a phlebologist will help you properly prepare for the upcoming surgical treatment.The patient has the right to ask any questions that interest him regarding the operation.

You should also describe the symptoms present as accurately as possible, talk about possible intolerance to certain medications, and be sure to inform about the medications you are currently taking.

The attending physician refers the patient to undergo a number of diagnostic procedures:

• blood and urine tests;
• fluorography;
• electrocardiography;
• duplex sonography.

The preparatory stage requires compliance with certain conditions:

1. 3 days before surgery, the patient must adhere to a slag-free diet, that is, fried, salty, spicy, as well as meat and flour products are prohibited.
2. The last meal and liquid intake is 8 hours before surgery.
3. For at least 3 days you should forget about alcohol and cigarettes.
4. You will need to remove hair from the leg on which the operation will be performed, and you should use a razor.
5. If there are ulcers, hematomas or any damage to the skin, you must notify your doctor.

If the patient drives a car, he should arrange for someone close or familiar to pick him up after discharge.It is currently prohibited to drive.

When preparing for surgery, the patient is interested in which type of surgical intervention is indicated for him and how much such treatment costs.If a patient is scheduled for vein surgery, the price is influenced by many factors: the stage of the disease, the length of the vessel affected by varicose veins, anesthesia, and so on.

Methods for removing varicose veins

Since there are many types of surgical treatment for varicose veins, the choice of a specific technique is made based on diagnostic data.In some cases, the venous vessel is partially or completely removed, in others, the veins that were deformed due to varicose veins are sealed or narrowed using a special substance.

Phlebectomy

A type of surgical treatment during which areas of blood vessels where varicose veins are present are excised.After removal, blood movement will be carried out through deep veins.

The operation is carried out as follows:

1. After the anesthesia has taken effect, the surgeon makes small incisions (up to 5 mm).
2. The vein is removed using a special probe, after which the affected area is resected.

The duration of phlebectomy is 1-2 hours.Subsequently, a small scar remains at the operated site.

Microphlebectomy

An excellent alternative to the previous method.The essence of the technique is that there is no need to make 5 mm incisions.A small puncture is enough to perform all the necessary manipulations with the vein.Moreover, the recovery in this case is much faster, and there are no scars left.

All types of operations performed to eliminate varicose veins of the legs go well and cause any complications in very rare cases.

Thanks to this puncture technique, it is possible to get rid of even large varicose veins.

Stripping

It is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.The surgeon pulls out the vessel affected by varicose veins through a small incision, using a special probe.Incisions are made in the area of the inguinal fold and ankle on the inside.

Stripping happens:

• partial– only part of the venous vessel is excised;
• total– the diseased vein is stretched along with its small branches.

Performing such manipulations requires maximum care from the doctor.If at least one uncrossed tributary remains, the risk of relapse increases significantly.

Sclerotherapy

This is a surgery to remove progressive varicose veins, which is minimally invasive and does not require any incisions.The surgeon’s actions are aimed at narrowing the lumen of the diseased vessel until it completely disappears.

To do this, a sclerosant is injected into a vein.The drug promotes irreversible damage to the walls of the vessel with subsequent overgrowth of the lumen.

Usually drugs specially designed for this purpose are used.

Sclerotherapy has several advantages:

• the procedure can be performed on an outpatient basis;
• the patient is allowed to return to everyday activities the next day;
• no need for general anesthesia;
• There are no scars after the operation.

A negative point is the likelihood of re-formation of varicose veins.The disease can affect the veins located next to those where the sclerosant was injected.Up to 10 injections are performed in one procedure, and the duration of treatment is about an hour.

It should be said about the types of sclerotherapy:

1. Foam.The drug used, in contact with air, forms foam, which fills the cavity of the vessel.Closing of the lumen occurs in a short period of time, and even a small amount of sclerosant is sufficient.In addition, to obtain satisfactory results, 1-2 procedures are carried out, during which the foam is injected a maximum of 3 times.
2. Microsclerotherapy.The technique is appropriate in the initial stages of the disease.
3. Echosclerosis.Prescribed for lesions of deep veins.The injection is done using an ultrasound scanner, which makes it possible to clearly distinguish the injection site of the sclerosant, accurately determine the amount of the drug and avoid undesirable consequences.

The manipulations performed are practically painless, and subsequently the patients recover quickly.

Laser coagulation

This method of treating varicose veins, called endovenous (endovasal) laser coagulation (obliteration), involves the use of a special device - a laser LED.

It is injected into the affected vein, and thanks to its radiation, the internal surfaces of the vessel are welded together.Blood continues to circulate through healthy veins, and the patient’s well-being improves.

Advantages of laser coagulation:

• absence of scars and age spots on the skin;
• carried out on an outpatient basis for 1-2 hours;
• local anesthesia is used;
• manipulations are performed under the control of an ultrasound machine;
• short recovery period.

The success of the operation can be finally judged after 3 months.The use of a laser guarantees complete relief from the disease without the risk of relapse.

The rehabilitation period after vein removal

After surgery, the patient must follow certain rules, which will minimize the risk of complications and speed up recovery:

1. Wearing compression stockings is recommended.The attending physician will help with his choice.At first (about 5 days), the underwear is not removed before bed, and subsequently its use is allowed only during the daytime.
2. To support blood vessels, alcohol and smoking should be prohibited, since nicotine and alcohol are one of the most common causes of varicose veins.
3. You should refrain from excessive physical activity.Even minor injuries to the lower extremities pose a danger.If the patient was previously fond of sports, he can return to exercise after 1.5-2 months.
4. To prevent relapses, water procedures should not be hot.Sauna, steam bath and solarium are contraindicated.
5. Cosmetic procedures cannot be performed on the operated areas.
6. It will be useful to perform therapeutic exercises.

To prevent varicose veins from returning after surgery, during the rehabilitation period you will need to take medications prescribed by your doctor to help the vessels recover.It is undesirable to change the dosage of medications at your own discretion, which is fraught with undesirable consequences.If any signs of deterioration appear, it is important to immediately see a phlebologist.

The type of surgical intervention is determined depending on the individual characteristics of the disease.

Possible complications after surgery

No specialist can guarantee the complete absence of side effects after surgery.Complications may occur depending on which method of surgical treatment was used.

Phlebectomy and stripping can result in:

• numbness in the lower legs;
• decreased sensitivity of the skin;
• pain syndrome;
• bleeding;
• hematomas;
• suppuration of the operated area.

After sclerotherapy, the following may appear:

• swelling of the ankle and foot;
• pigmentation;
• peeling and itching;
• painful sensations;
• skin burn.

If a laser LED was used, the formation of:

• inflammation;
• darkening of skin areas;
• minor bruising;
• nagging pain.

The most dangerous complication of any surgical procedure is thrombosis.But its occurrence is observed in rare cases.With minimally invasive surgery, the risk of blood clots is quite low.

Thanks to surgical treatment, it is possible to successfully get rid of a serious disease.The main thing is to find a qualified specialist and not ignore medical recommendations regarding the recovery period.