Surgery to remove varicose veins in the legs

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

Indications and whether surgery is necessary at all

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

The operation will be justified in the following cases:

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

In a direct conversation with the doctor, he will be able to determine if it is worth doing the surgery, and also talk about the types of surgical interventions that generally exist.

Contraindications to surgical treatment of varicose veins

Despite the strong indications, there are many cases when surgery to remove varicose veins in the leg cannot be performed. For example, if a patient has the final stages of varicose veins, then surgical treatment will not always be possible. In such cases, doctors focus on medication, but they may not 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 transferred thrombosis or pulmonary embolism;
• active process of destruction of atherosclerosis;
• old age;
• period of pregnancy.

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

Sclerotherapy technique

Scleotherapy is a procedure, the principle of which is to inject a special substance into the affected vessel, causing further contraction and excessive enlargement 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 phase of sclerotherapy, a 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 the sclerosant, the vein gradually narrows, and then grows and disappears.

There are two types of manipulation:

1. Microsclerosis. Ied is justified in the initial stages of varicose veins, when the smaller vessels that extend most superficially are involved in the process. In such cases, the amount of sclerosant needed is minimal.
2. Ecosclerosis. It is performed in the deepest veins using duplex scanning in order to accurately determine the location of the 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 done under local anesthesia, does not require large incisions and tissue trauma and has an immediate effect.

The vascular surgeon must show 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 wavelength, passes through this apparatus and acts on the walls of varicose vessels. Under its action, the container is clogged and blocked.

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

Connection of veins

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

The operation is performed on foot more often than on vessels in the pelvic area. The saphenous vein ligation technique will be effective. The vascular surgeon enters the vessel shown at the point where the saphenous vein joins the femoral vein. Next, the surgeon performs bandage with special threads.

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

Removal of enlarged vessels

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

To remove the enlarged vessel, the surgeon needs a long incision of only 0. 5-1 cm. After opening the entrance to the varicose vein area, the surgeon ligates the vessel, crosses it, and removes it.

As a subspecies of this intervention, miniflebectomy is distinguished. It differs from conventional phlebectomy in that the surgeon needs a puncture rather than an incision to enter the vessel. This operation is effective for touching small superficial vessels. Its main plus is that it leaves no traces and cosmetic defects.

exposure

Removal 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 inserts it into the vessel. Then the doctor makes another incision - in the region of the waist or lower leg.

Through the upper entrance to the large saphenous vein, a special probe is inserted - an extraction probe. The surgeon pre-bandages the mouth of the adjacent veins. The probe passes along the entire length of the vessel to the lower incision, after which it is used to remove the vein.

In undressing, several types of manipulation are also distinguished:

1. Short undress. Not the entire vessel is eliminated, but only a certain area that undergoes the varicose vein 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

Having varicose veins, surgery can have the opposite effect and cause various complications. They should be separated by 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 appearance of general weakness are possible. Depending on the rules of the postoperative period, the symptoms disappear within two days.
2. After undergoing laser coagulation, the patient may experience a feeling of tension in the thigh area, minor hemorrhages, and an increase in body temperature. With proper treatment, the symptoms disappear within a week.
3. Venous 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, numbness in the legs, pain at the cutting sites.

For all methods of surgical treatment, there is a common complication - thrombosis. This is a dangerous process, but the chance of its occurrence as a result of any surgery is very low.

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

Depending on the rules of the postoperative period, the symptoms disappear within two 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, it is necessary to wear special compression underwear - it can be in the form of socks, tights, socks and for this purpose you can also use a regular elastic bandage.
• Eliminate bad habits - alcohol consumption, smoking, drug use.
• Avoid baths and saunas, as well as making baths too hot.
• In the place where the operation was performed, you can not perform any cosmetic procedure and apply different cosmetics.
• Avoid strenuous physical activity. If before treatment the patient is involved in some kind of sport (especially difficult), then after surgery, large loads should be forgotten for at least 5-8 weeks. In the future, you should consult your doctor if it is possible to continue intense sports.
• Do daily prophylactic exercises that last no more than 15-30 minutes.
• Adhere to phlebologist prescriptions - take regular prophylactic anticoagulants, phlebotonics, non-steroidal anti-inflammatory drugs, thrombolytics and other medications.

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