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 are usually ignored, the pathology continues to develop, reducing the effectiveness of the means used. With a significant worsening of symptoms, the only option that removes 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, surgery is indicated in some cases.

In particular, surgery is indicated for patients with:

• extensive vascular lesions, which can be determined by visual examination;
• symptoms of edema, constant aching pain and a feeling of heaviness;
• a significant risk of thrombophlebitis, trophic ulcers.

Varicose vein surgery is appropriate when the use of drugs does not bring the desired results. It is important not to allow the development of the disease until such time as surgical treatment is useless.

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

Contraindications

Surgery in the last stage is often inappropriate, therefore, varicose veins are treated with various drugs. They contribute to a certain reduction in the severity of the disease, but cannot completely eliminate it.

Surgical procedures are prohibited for patients suffering from:

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

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

Preparing for surgery

A consultation with a phlebologist will help you prepare competently for the next surgical treatment. The patient has the right to ask any questions of interest to him relating to the operation.

You should also describe your symptoms as accurately as possible, talk about possible intolerance to certain medications, and be sure to inform about medications currently in use.

The attending physician orders the patient to undergo a series of diagnostic procedures:

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

The preparatory phase requires compliance with certain conditions:

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

If a patient drives a car, he or she should agree with someone close or an acquaintance to pick him up after discharge. While driving is prohibited.

Preparing for the operation, the patient is interested in what type of surgery is indicated for him and how much such treatment costs. If a patient is prescribed vein surgery, many factors affect the price: 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 particular technique is made on the basis of diagnostic data. In some cases, the venous vessel is partially or completely removed, in others - the veins, which have been deformed with varicose veins, are sealed or narrowed with a special substance.

Phlebectomy

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

The operation is performed as follows:

1. After the anesthesia is effective, 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.

Phlebectomy lasts 1-2 hours. Subsequently, a small scar remains on the operated site.

Microflebectomy

Excellent alternative to the previous method. The essence of the technique is that it is not necessary to make 5 mm incisions. A small puncture is enough to perform all the necessary manipulations with the vein. In addition, the recovery in this case is much faster, with no scars left.

All kinds of operations performed to eliminate varicose veins in the legs are successful and cause complications in very rare cases.

Thanks to this puncture technique, it is possible to eliminate even large varicose veins.

Stripping

This is a type of phlebectomy. With its help, the trunk of the great saphenous vein is removed. The surgeon drags the vessel affected by varicose veins through a small incision using a special probe. The incisions are made inside the groin and ankle.

Stripping is performed:

• partial- only part of the venous vessel is removed;
• total- the diseased vein is extracted together with small branches.

Carrying out such manipulations requires the utmost care from the doctor. If there is at least one uncrossed influx, the risk of relapse increases significantly.

Sclerotherapy

This is a progressive varicose vein removal operation which is minimally invasive and does not require incisions. The surgeon's actions are aimed at narrowing the lumen of the diseased vessel until it completely disappears.

For this, a sclerosing agent is injected into a vein. The drug promotes irreversible damage to the vessel walls, followed by an overgrowth of the lumen.

Usually specially designed preparations are used.

Sclerotherapy has several advantages:

• the procedure can be performed on an outpatient basis;
• the patient can return to daily chores the next day;
• no need for general anesthesia;
• no scar after surgery.

A negative point is the likelihood of varicose vein reformation. The disease can affect the veins located next to those in which the sclerosing agent was injected. Up to 10 injections are performed in one procedure and the treatment duration is approximately one hour.

It should be said about the types of sclerotherapy:

1. Foam.The preparation used, in contact with the air, forms a foam which fills the vessel cavity. The closing of the lumen occurs in a short period of time, while even a small amount of sclerosing agent is sufficient. In addition, to achieve satisfactory results, 1-2 procedures are performed, during which the foam is injected up to 3 times.
2. Microsclerotherapy.The technique is appropriate in the early stages of the disease.
3. Ecosclerosis.It is prescribed for deep vein injuries. The injection is performed using an ultrasound scanner, which allows you to clearly distinguish the place of injection 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 intravenous (intravascular) 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. Blood continues to circulate in healthy veins and the patient's well-being improves.

Advantages of laser coagulation:

• lack of scars and age spots on the skin;
• is ​​performed 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 final judgment on the success of the operation is possible in 3 months. Using a laser guarantees complete recovery from the disease without the risk of relapse.

Rehabilitation period after removal of the vein

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

1. It is recommended to wear compression stockings. The attending physician will help in his choice. At first (about 5 days) the linen is not removed before going to bed, later its use is allowed only during the day.
2. To maintain blood vessels, alcohol and smoking should be banned, as nicotine and alcohol are one of the most common causes of varicose veins.
3. You should refrain from excessive physical exertion. Minor injuries to the lower limbs are also dangerous. If the patient was previously fond of sports, it is possible to return to classes in 1, 5-2 months.
4. To prevent relapse, water treatments should not be hot. Sauna, steam bath and solarium are contraindicated.
5. It is not possible to perform cosmetic procedures on the operated areas.
6. It will be useful to perform therapeutic exercises.

To avoid the return of varicose veins after the operation, during the rehabilitation period, it will be necessary to take medications prescribed by the doctor, which will help the vessels to recover. It is undesirable to change the dosage of drugs at one's own discretion, which is fraught with undesirable consequences. If signs of deterioration appear, it is important to consult a phlebologist immediately.

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

Possible complications after surgery

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

Phlebectomy and stripping can change:

• 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;
• burning of the skin.

If a laser LED was used, it is possible that:

• inflammation;
• darkening of skin areas;
• minor bruises;
• pull the 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 to ignore the medical recommendations related to the recovery period.