Surgery to remove varicose veins on the legs

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

Indications and if surgery is needed

Surgery to remove varicose veins is a radical approach to treating pathological vessels, so the indications 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 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 the operation is worth doing, and also talk about what types of surgeries exist in general.

Contraindications to the surgical treatment of varicose veins

Despite the strong indications, there are many cases where surgery to remove varicose veins on the legs is not possible. For example, if a patient has the last stages of varicose veins, surgical treatment will not always be possible. In these cases, doctors focus on medications, but they can't 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 heart 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 medications for other diseases, it is necessary to inform the attending physician.

Sclerotherapy technique

Sclerotherapy is a procedure, the principle of which 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 surgical incisions or 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, a specialist gives 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 the sclerosant, the vein gradually narrows, then it grows excessively and disappears.

There are two types of manipulation:

1. Microosclerosis. It is justified in the initial stages of varicose veins, when small vessels that are more superficially are involved in the process. In these cases, the amount of sclerosant needed is minimal.
2. Echosclerosis. It is performed on deeper veins using duplex scanning to more accurately determine the location of deep varicose veins.

Laser coagulation

Laser surgery for varicose veins 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 tissue incisions and trauma, and has an immediate effect.

The vascular surgeon should 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 varicose vessels. Under its action, the vessel coagulates and becomes clogged.

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 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 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. After that, the surgeon performs the 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 method of surgery is phlebectomy. Doctors do it almost every day, and it's cheaper than laser coagulation or sclerotherapy. This operation 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 the access to the area with varicose veins, the surgeon ties 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 for targeting small superficial vessels. Its main advantage is that it leaves no traces and aesthetic defects.

striptease

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 saphenous vein and accesses the vessel. Then the doctor makes another incision - in the middle or lower region of the leg.

Through the superior access into the great saphenous vein, a special probe is introduced - 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.

In stripping, several types of manipulation are also distinguished:

1. Short striptease. Not the entire vessel is eliminated, but only a certain area prone 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 avoid further relapses.

Consequences of surgery and rehabilitation

Having varicose veins, the operation can have the opposite effect and cause various complications. They must be separated for the type of intervention performed:

1. After sclerotherapy, the patient may experience itching, burning, skin discoloration and edema at the injection site. An increase in body temperature and the occurrence of general weakness are possible. Subject to the rules of the postoperative period, the symptoms disappear in a couple of days.
2. After undergoing laser coagulation, the patient may experience a feeling of tension in the thigh area, small bleeding and an increase in body temperature. With proper treatment, symptoms go away within a week.
3. Vein 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 sensation, 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 possibility of it occurring as a result of any operation is very low.

To avoid the above complications and to shorten the rehabilitation period as much as possible, it is necessary to adhere to the recommendations for health and blood vessel care in the postoperative period.

Subject to the rules of the postoperative period, the symptoms disappear in a couple of days.

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

• Immediately after the end of the operation and in the first week after it, it is necessary to wear special compression underwear - it can be in the form of stockings, tights, socks, and for this purpose you can also use an ordinary elastic bandage.
• Eliminate bad habits: alcohol consumption, smoking, drug use.
• Avoid baths and saunas, as well as taking too hot baths.
• In the place where the operation was performed, it is not possible to carry out any cosmetic procedures and apply various cosmetics.
• Avoid strenuous physical activity. In the event that before the treatment the patient was involved in any type of sport (particularly hard), 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 playing intensive sports.
• Do daily prophylactic exercises lasting no more than 15-30 minutes.
• To adhere to the prescriptions of the phlebologist for taking medications - to regularly carry out prophylactic anticoagulants, phlebotonics, non-steroidal anti-inflammatory drugs, thrombolytics and other drugs.

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