What types of operations are prescribed for varicose veins?

Conservative methods of treatment are effective only in the early stages of varicose veins. And as the first signs are usually ignored, the pathology continues to develop, reducing the effectiveness of the means used. With significant worsening of symptoms, the only option that removes varicose veins is surgery. A special place is occupied by rehabilitation, which requires the patient to comply with medical recommendations.

Indications for surgery

In the presence of varicose veins, 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 pain and a feeling of heaviness;
• a significant risk of thrombophlebitis, trophic ulcers.

Varicose vein surgery is indicated when the use of medications does not bring the desired results. It is important not to allow the disease to develop until the time when surgical treatment is useless.

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

Contraindications

Surgery at the last stage is usually inadequate, so varicose veins are treated with various medications. They contribute to some reduction in the severity of the disease, but they cannot eliminate it completely.

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 diseases (coronary artery disease, hypertension, heart failure);
• acute form of phlebitis;
• infectious diseases (surgery is possible after recovery);
• venous thrombosis, pulmonary embolism (in history);
• atherosclerosis obliterating of the vessels of the lower extremities.

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

Preparation for surgery

An appointment with a phlebologist will help you to competently prepare for your next surgical treatment. The patient has the right to ask any questions of interest related to the operation.

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

The responsible physician advises the patient to undergo a series of diagnostic procedures:

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

The preparatory phase requires the fulfillment of certain conditions:

1. 3 days before the operation, the patient must adhere to a slag-free diet, that is, fried, salty, seasoned products, as well as meat and flour derivatives are prohibited.
2. Last meal and fluid intake 8 hours before surgery.
3. For at least 3 days, you must 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 blade.
5. If you have abscesses, bruises or any skin lesions, tell your doctor.

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

Preparing for the operation, the patient is interested in what type of surgical intervention is indicated for him and how much this treatment costs. If venous surgery is prescribed for a patient, 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

As there are many types of surgical treatment for varicose veins, the choice of a particular method is made based on the diagnostic data. In some cases, the venous vessel is removed partially or totally, in others - the veins, which were deformed with the varicose veins, are sealed or narrowed with a special substance.

Phlebectomy

A type of surgical treatment, during which areas of the vessels where varicose veins are present are excised. After removal, blood circulation will be carried out through 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 with a special probe, after which the affected area is resected.

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

Microflebectomy

Great 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 sufficient to perform all the necessary manipulations with the vein. In addition, recovery in this case is much faster, without leaving scars.

All types of operations performed to remove 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.

Peeling

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

Removal happens:

• partial- only part of the venous vessel is excised;
• total- the diseased vein is pulled out along with small branches.

Performing such manipulations requires the utmost care of the doctor. If there is at least one non-crossed inflow, the risk of relapse increases significantly.

Sclerotherapy

This is an operation to remove progressive varicose veins, 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 disappears completely.

For this, a sclerosing agent is injected into a vein. The drug promotes irreversible damage to the vessel walls with subsequent excessive growth of the lumen.

Specially designed preparations are generally used.

Sclerotherapy has several advantages:

• the procedure can be performed on an outpatient basis;
• the patient is allowed to return to daily tasks the next day;
• without the need for general anesthesia;
• without scarring after surgery.

A negative point is the probability of re-formation of varicose veins. The disease can affect the veins located close to those where the sclerosing agent was injected. Up to 10 injections are performed in one procedure and the duration of treatment is about one hour.

It should be said about the types of sclerotherapy:

1. Foam.The preparation used, in contact with air, forms foam, which fills the cavity of the vessel. The closing of the lumen occurs in a short period of time, and even a small amount of sclerosing is sufficient. In addition, to obtain satisfactory results, 1-2 procedures are performed, during which the foam is injected a maximum of 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 done in an ultrasound device, which allows to clearly distinguish the injection site from the sclerosing agent, accurately determine the amount of the medication and avoid undesirable consequences.

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

Laser coagulation

This method of treating varicose veins, called intravenous (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. Blood continues to circulate through healthy veins and the patient's well-being improves.

Pros of laser coagulation:

• absence 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. The use of the laser ensures complete recovery from the disease without risk of recurrence.

Rehabilitation period after removal of the vein

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

1. The use of compression stockings is recommended. The attending physician will assist in your choice. At the beginning (about 5 days), the bed linen is not removed before going to bed and, later, its use is allowed only during the day.
2. In order to maintain blood vessels, alcohol and smoking should be prohibited, since nicotine and alcohol are one of the most common causes of varicose veins.
3. You must refrain from excessive physical efforts. Even minor injuries to the lower extremities are dangerous. If the patient previously liked sports, it is possible to return to classes in 1, 5-2 months.
4. To avoid relapse, water treatments should not be hot. Sauna, steam bath and solarium are contraindicated.
5. No cosmetic procedures can be performed on the operated areas.
6. Performing therapeutic exercises will be helpful.

To prevent the return of varicose veins after the operation, during the rehabilitation period, you will need to take medications prescribed by your doctor, which will help in the recovery of the vessels. It is not desirable 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 see a phlebologist immediately.

The type of surgery is determined according to the individual characteristics of the disease course.

Possible complications after surgery

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

Phlebectomy and removal can change:

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

After sclerotherapy it may appear:

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

If a laser LED was used, the formation of:

inflammation
• ;
• darkening of the skin areas;
• small bruises;
• pulling 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 get rid of a serious illness successfully. The main thing is to look for a qualified specialist and not ignore medical recommendations regarding the recovery period.