Surgery to remove varicose veins in the legs

Faced with problems such as varicose veins in the lower legs, patients should not hesitate to see a doctor and start treatment. An experienced specialist will conduct a thorough examination and draw conclusions about which therapeutic tactic is best taken: conservative treatment or surgery. If, for some reason, such drugs are unable to have the desired effect on the patient's blood vessels, then the doctor prescribes surgical intervention, which can already help unconditionally.

Indications and whether surgery is needed at all

Surgery to remove varicose veins is a radical approach to the treatment of pathological ducts, so indications for that would be appropriate.

Operation will be allowed in the following cases:

• the amount of varicose veins in the lower part of the leg, which can be seen with the naked eye;
• persistent swelling of the feet, discomfort, pain and heaviness in the feet or other places, depending on the localization of the pathological process;
• a direct threat that varicose veins present in certain parts of the body will be complicated by more dangerous diseases (e. g. , thrombophlebitis, trophic ulcers or pulmonary embolism).

In a direct conversation with the doctor, he or she will be able to determine if surgery should be performed, as well as discuss the types of surgical interventions available in general.

Contraindications to surgical treatment of varicose veins

Although there are strong signs, there are many cases where surgery to remove varicose veins in the legs cannot be performed. For example, if a patient has end -stage varicose veins, then surgical treatment will not always be feasible. In such cases, doctors focus on medications, but they can’t help enough.

Some other mandatory contraindications:

• the presence of skin diseases at the site of the affected veins, for example, eczema, pyoderma, dermatitis, etc.
• severe diseases of the cardiovascular system - hypertension, coronary artery disease, heart failure;
• acute inflammatory processes in the vessels (phlebitis);
• thrombosis or embolism of the previously transplanted lung;
• active process of eliminating atherosclerosis;
• old age;
• gestation period.

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

Sclerotherapy techniques

Sclerotherapy is a procedure, the principle of which is to inject a special substance into the affected vessel, causing shrinkage and growth of larger vessels. The main advantage of this method is that the procedure does not require incision or surgical access.

The essence of the procedure is as follows: with the help of a syringe, the doctor injects sclerosing material into the pathological vessel. During one stage of sclerotherapy, a specialist makes two to ten such injections. The effect does not appear at the same time - usually requires 2-8 weeks and several sessions of such a procedure. Under the action of sclerosant, the veins gradually narrow, and then grow and disappear.

There are two types of manipulation:

1. Microsclerosis. This is allowed in the early stages of varicose veins, when small vessels that lie more superficially are involved in the process. In such cases, the amount of sclerosant required is minimal.
2. Echosclerosing. It is performed on the deep veins using duplex scans to determine the localization of varicose veins more accurately.

Laser freezing

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 a direct effect.

The vascular surgeon should tell in detail about how the operation is performed, but, in general, the point lies in the introduction of a special laser light guide into the aching vessel. The laser beam, which has its own wavelength, passes through this device and acts on the walls of the varicose veins. Under his action, the ship froze and clogged.

This technique will be allowed if the patient has varicose veins of the legs or groin area. Moreover, 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 not allowed.

Vein ligament

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

Surgery is performed on the legs more often than on vessels in the pelvic area. The saphenous vein ligation technique will be effective. The vascular surgeon enters the indicated vessel at the point where the saphenous vein joins the femoral vein. Next, the surgeon performs a bandage with a special thread.

In women, pelvic vein surgery can be performed. In this case, the ovarian veins are accessed and tied.

Removal of widened vessels

The most common and proven surgical method is phlebectomy. Doctors do it almost every day, and is more affordable than laser coagulation or sclerotherapy. Such surgeries for varicose veins are performed under general anesthesia or with epidural anesthesia.

To remove the dilated vessel, the surgeon requires an incision of only 0, 5-1 cm. After opening the entrance to the area with varicose veins, the surgeon tied the vessel, crossed it and removed it.

As a subspecies of this intervention, miniflebectomy was distinguished. It differs from conventional phlebectomy in that the surgeon requires a puncture rather than an incision to enter the vessel. This operation is effective for affecting small shallow vessels. Its main advantage is that it does not leave cosmetic traces and blemishes.

Stripping

Stripping is one subtype of phlebectomy, in which a special probe is used to remove the vein. Like simple varicose vein removal, the surgeon makes an incision in the saphenous vein and enters the vessel. Then the doctor makes another incision - in the middle or lower leg area.

Through the upper access to the large saphenous vein, a special probe is introduced - the extractor probe. The surgeon wraps the mouth of the adjacent vein. The probe is passed along the 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 stripping. Not all vessels are removed, but only certain areas that experience the varicose process.
2. Amount. Such surgery for varicose veins in the lower part of the leg allows you to get rid of large areas of diseased ducts and prevent further recurrence.

Consequences of surgery and rehabilitation

Suffering from 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, patients may experience itching, burning, skin discoloration and the appearance of edema at the injection site. An increase in body temperature and the occurrence of general weakness are possible. Subject to the rules in the postoperative period, symptoms disappear within a few days.
2. After undergoing laser coagulation, patients may experience tension in the thigh area, light bleeding, 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 can be accompanied by loss of sensitivity, numbness 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 happening as a result of any operation are very low.

To avoid the complications mentioned above and to shorten the recovery time as much as possible, you must adhere to the recommendations to take care of your health and blood vessels in the postoperative period.

Subject to the rules in the postoperative period, symptoms disappear within a few days.

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

• Immediately after the operation is over and in the first week thereafter, you need to wear special compression underwear - can be in the form of stockings, tights, socks, and for this purpose you can also use regular elastic bandages.
• Get rid of bad habits - alcohol intake, smoking, drug use.
• Avoid baths and saunas, as well as baths that are too hot.
• At the place where the operation is performed, you cannot perform cosmetic procedures and use various cosmetics.
• Avoid strenuous physical activity. If before treatment the patient is engaged in any kind of sport (especially difficult), then after surgery, heavy loads should be forgotten for at least 5-8 weeks. In the future, you should see your doctor if you are able to continue intensive sports at all.
• Perform prophylactic exercises daily for no more than 15-30 minutes.
• To comply with the prescription of a phlebologist to take medication - to perform common prophylactic anticoagulants, phlebotonics, non -steroidal anti -inflammatory drugs, thrombolytics and other drugs.

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