What types of operations are prescribed for varicose veins?

Conservative methods of treatment are effective only in the initial stages of varicose veins. And since usually the first signs are 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, surgical treatment is indicated in certain 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 veins surgery is appropriate when the use of medications does not bring the desired results. It is important not to allow the development of the disease until the moment when the surgical treatment is useless.

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

Contraindications

Surgery at the last stage is often inappropriate, therefore, varicose veins are treated with various drugs. They help to somewhat reduce the severity of the disease, but they 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 artery 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 extremities.

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

Preparing for surgery

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

You should also describe the symptoms present as accurately as possible, talk about possible intolerance to certain medications and be sure to inform about the medications currently being taken.

The attending physician directs the patient to undergo a number of diagnostic procedures:

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

The preparatory stage involves meeting certain conditions:

1. 3 days before the operation, the patient must adhere to a slag-free diet, that is, fried, salted, 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 to be operated on, and use a razor.
5. If you have abscesses, bruises or any lesions on the skin, notify your doctor.

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

Preparing for the operation, the patient is interested in what type of surgical intervention 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 based on the diagnostic data. In some cases, the venous vessel is partially or completely removed, in others - the veins, which were 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 excised. After removal, the movement of blood will be carried out through deep veins.

The operation is carried out 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

Great alternative to the previous method. The essence of the technique is that there is no need to make 5 mm incisions. A minor puncture is enough to perform all the necessary manipulations with the vein. Moreover, the recovery in this case is much faster, with no scars left.

All types of operations carried out to eliminate varicose veins of the legs are successful and cause any complications in very rare cases.

Thanks to this puncture technique, it is possible to get rid of 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 pulls the vessel affected by varicose veins through a small incision, using a special probe. Incisions are made on the inside of the groin and ankle.

Stripping happens:

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

Performing such manipulations requires maximum care from the doctor. If there is at least one uncrossing inflow left, 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 sclerosant is injected into a vein. The drug promotes irreversible damage to the vessel walls with subsequent overgrowth of the lumen.

Specially designed preparations are usually used.

Sclerotherapy has several advantages:

• the procedure can be carried out on an outpatient basis;
• the patient is allowed to return to everyday affairs the very next day;
• no need for general anesthesia;
• no scars after surgery.

A negative point is the probability of re-formation of varicose veins. The disease can affect the veins located next to those where the sclerosant was injected. Up to 10 injections are performed in one procedure, and the duration of treatment is about an 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 closure of the lumen occurs in a short period of time, while even a small amount of sclerosant is sufficient. In addition, to obtain satisfactory results, 1-2 procedures are carried out, during which the foam is injected a maximum of 3 times.
2. Microsclerotherapy.The technique is appropriate at the initial stages of the disease.
3. Echosclerosis.It is prescribed for lesions of deep veins. The injection is done 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 performed manipulations are practically painless, and subsequently the patients recover quickly.

Laser coagulation

This method of treating varicose veins, called endovenous (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 inner surfaces of the vessel are soldered. Blood continues to circulate through healthy veins, and the patient's well-being improves.

Pros of laser coagulation:

• lack of scars and age spots on the skin;
• is ​​carried out on an outpatient basis for 1-2 hours;
• local anesthetic is used;
• manipulations are performed under the control of an ultrasound machine;
• short recovery period.

The final judgment about the success of the operation is possible in 3 months. The use of a laser guarantees complete recovery from the disease without the risk of relapse.

Rehabilitation period after vein removal

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

1. Wearing compression hosiery is recommended. The attending physician will help with his choice. At first (about 5 days), the linen is not removed before going to bed, and later its use is allowed only during the daytime.
2. 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 should refrain from excessive physical exertion. Even minor injuries of the lower extremities are dangerous. If the patient was previously fond of sports, it is possible to return to classes in 1. 5-2 months.
4. To prevent relapses, 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 useful.

To prevent varicose veins from returning after the operation, during the rehabilitation period, you will need to take medications prescribed by your doctor, which will help the vessels to recover. It is undesirable to change the dosage of drugs 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 depending 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 which method of surgical treatment was used.

Phlebectomy and stripping can turn around:

• 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;
• skin burn.

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

• inflammation;
• darkening of skin areas;
• minor bruising;
• pulling 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 illness. The main thing is to find a qualified specialist and not to ignore medical recommendations regarding the recovery period.