Choosing the optimal approach to deal with varicose veins is an urgent issue faced by patients and phlebotomists. In the early stages of the development of the pathology, mainly conservative methods of treatment are used, which preserve varicose veins. However, if such a technique becomes ineffective, the only suitable option that can change the situation for the better is surgery to remove the veins in the legs. Surgical intervention is the most radical approach to varicose veins, as distal areas of damaged vessels simply cannot change the varicose veins back.
In this article we will consider the types of surgery to remove veins for varicose veins that modern vascular surgery can offer: their characteristics, pros and cons, preparatory featuresand implementation, as well as rehabilitation and possible complications.
What can be achieved with leg vein surgery?
Surgical intervention for varicose veins aims to address the following problems:
- Eliminate reflux - a reflux pathology caused by venous insufficiency.
- Remove veins. Recommended if a vein has undergone a severe transformation and there is no hope of restoring normal blood flow in it. In this case, the portion of the vessel that affects the varicose veins is removed and the blood is thus redistributed through the healthy veins.
- Against cosmetic defects. Since CVI (chronic venous insufficiency) and varicose veins do not alter the appearance of the lower extremities in the best way, surgery should be aimed at removing cosmetic defects.
Varieties of vein surgery
The types of surgical interventions that modern vasectomy can provide to combat varicose veins are divided into two groups:
- The operation is aimed at mechanical excision of the veins affected by varicose veins with their subsequent ligation.
- Activities involving heat or chemical exposure to varicose veins.
The choice of the most appropriate method of leg vein surgery depends on the stage of disease development, the age and general health of the patient, as well as the goals pursued during surgery.
Vein removal of the lower extremities: surgical process
Combined phlebectomy (venous ablation) is the "gold standard" in surgery for venous insufficiency.
This method is used to remove varicose veins.
There are many types of surgery, each of which is named after its inventor: phlebotomy according to Bebkokk, according to Narat, according to Mueller, performed under local anesthesia (with extensive vascular damage - ingeneral conditions).
Despite the differences, all of these leg vein removal operations have one thing in common: they involve making cuts or punctures in the skin that range from 1 mm to 5-6 cm in length, through which the surgeon pulls the affected vein to the surface using a special hook. The veins are cut off, tied up and removed, and then sutured or a special plaster is applied to the skin. This operation to remove varicose veins in the legs is highly effective and allows you to achieve positive results in the treatment of varicose veins.
Laser vein surgery
With the development of medicine in the arsenal of vascular surgeons, more modern and less traumatic varicose vein surgery methods began to appear compared to the classical surgical intervention. . With their help, it is possible to reduce the duration of the procedure, minimize scarring after surgery, and also reduce the possibility of complications and side effects. One of these methods is laser surgery on the veins of the lower extremities (intravascular, endothelial or endovascular laser coagulation).
A special laser light guide is inserted into the cavity of the affected vessel, heating the blood and vein wall. Under the influence of high temperatures up to 120 degrees, the vessel walls stick together, as a result, blood stops flowing into this part of the circulatory system.
Expert opinion
Depending on the area of the lesion and the number of veins to be removed, varicose vein treatment in this way usually requires several sessions lasting 30-60 minutes.
Laser vein removal surgery has less damage, gives good aesthetic effect (after surgery, there are no scars and scars on the skin), no long-term hospital stay is required. However, it should be borne in mind that this technique is not suitable for the treatment of late stages of venous insufficiency, when the diameter of the veins increases significantly and varicose veins appear; To remove them, traditional surgical intervention will be required. .
Therapeutic therapy
This is another modern vein removal surgery that allows you to achieve remarkable results with minimal trauma. Atheroma is injected into the dilated vessel lumen - a special liquid or foam that sticks to the walls of the affected area of the vein. Performing the treatment of concave scars helps you achieve quick aesthetic results without leaving scars, so it is very popular. However, this procedure is only suitable for the early stages of varicose veins, as well as varicocele.
Radiofrequency vein surgery
RFA (radiofrequency ablation) is the impact on the affected area of the blood vessel with radio signals of a certain frequency, resulting in heating of the vein wall, destruction of the endothelium and subsequent sealing of the lumen. . The procedure is minimally invasive and requires no hospital stay.
Preparing for vein surgery
Before surgery, it is necessary to conduct preparatory measures: lower extremity venous ultrasound, subclinical blood tests and coagulation tests. On the eve of the procedure, you need to shave your legs without using creams, gels and other cosmetics.
Expert opinion
If you are planning to have general anesthesia, you should fast for 8 hours before the procedure (although in some cases, your doctor may allow a light meal). In addition, a cleansing enema may be required prior to general anesthesia.
Contraindications to leg vein surgery
These surgical interventions are not recommended during pregnancy, with serious endocrine and cardiovascular pathologies, at the time of exacerbation of chronic diseases, in the presence of infectious andinflammation in the legs.
Rehabilitation after vein surgery
The length of the recovery period depends on the number of veins removed, the patient's general health, and adherence to the vascular physician's recommendations.
Typically, the recovery period lasts from 2 months to six months.
Depending on the type of surgery, limited activity may be recommended for the patient during recovery. For example, after laser coagulation and sclerotherapy, you can get up and move immediately, after sclerotherapy, you have to walk for about an hour, while combined veinectomyrequires a certain period of restriction.
Recommendations for rehabilitation after leg vein surgery
To reduce the risk of recurrence and postoperative complications, the following restrictions and recommendations should be observed:
- You should wear knitted clothing with proper compression. Stockings or stockings after venous surgery are a prerequisite for the restoration of normal blood flow in the lower extremities.
- Correct the load on the leg. It is important to choose the "golden vehicle" here: complete immobility and standing, sitting, and running for long periods of time should not occur.
- Do not lift weights (during the recovery period, the maximum allowable weight is up to 5 kg).
- Do not take a hot bath, do not take a sauna, steam bath, avoid contact with vascular skin areas far from direct sunlight for a while.
- Wear loose-fitting pants or skirts, and forgo tight, uncomfortable shoes (especially with heels).
- Take medicine prescribed by your doctor. Usually, the intake of venotonics, anticoagulants, antioxidants is prescribed.
Consequences and complications after venous surgery
Any surgical intervention can have undesirable consequences, and lower extremity vein surgery is no exception. Potential complications include:
- Recurrent episodes of varicose veins. If the cause of varicose veins is not eliminated, there is a high chance that the disease will recur. Therefore, in addition to leg vein surgery, it is necessary to conduct a comprehensive treatment of the pathology and eliminate provoking factors.
- Temperature increase. A slight increase in local temperature in the area of the excised vein is normal in the postoperative period. In addition, for 1-2 days after the end of the procedure, the total body temperature can remain below the threshold.
- Hematoma mass. Bruising after vein surgery is a common complication after vein removal. It is due to perforation of the jar. Small bruises usually clear up on their own without further treatment within a few weeks. However, if you have a large and painful bruise that doesn't go away in about 2 weeks, report it to your vein doctor.
- Pigmentation disorder. Discoloration of the skin at the surgical site usually persists for several weeks and then resolves on its own. It should be noted that hyperpigmentation is a very common complication following sclerotherapy.
To avoid these unpleasant phenomena, do not ignore medical recommendations, be sure to wear knitwear and take the medications recommended by the phlebologist.