What is the most effective surgery to remove varicose veins on the legs?

Types of surgery to remove varicose veins

Removal of veins in the lower limbs is called a radical treatment. If conservative and alternative treatment methods do not have adequate therapeutic effects and the disease continues to develop, the patient can be prescribed surgery to remove varicose veins in the legs.

Using advanced forms of varicose veins, surgery can solve the following tasks:

  • Eliminates the pathological backflow of blood (reverse flow).
  • Keep healthy areas of the saphenous vein that are not affected by disease.
  • Eliminate the affected area of ​​the vein.

Before the operation, the doctor will mark the vein under ultrasound control, which allows you to determine the boundaries of the affected part. Use a narrow probe to remove the affected part of the blood vessel and vein, which is inserted through a small incision. After the affected area is removed, the risk of the disease recurring is small.

After surgical removal of varicose veins, there is little chance of the disease recurring.

In modern medicine, combined venous resection is the first choice, which involves the use of multiple techniques at once.

The main stages of combined radical treatment are: upper or lower cross resection, short stripping, venipuncture ligation, and venule resection.

In the initial stages of the disease, any of the listed procedures can be used as a stand-alone surgery. In some cases, minimally invasive treatment in the form of sclerotherapy or laser occlusion can be provided as an alternative to some stages of the classic combined venectomy.

Operation type

How to perform varicose vein extraction

The general term for surgery to remove the affected vein is venectomy. Modern type of this process:

  • Peeling(long or short) is the most gentle technique in which the doctor can only remove specific parts of the affected vein. The procedure is performed through a small incision along the vein.
  • Laser Vein Extractionis ​​a modern treatment that involves the use of lasers. With this instrument, the laser coagulation process takes place inside the affected blood vessel. The process is carried out under local anesthesia and does not require the use of special surgical instruments. The laser is inserted into the vein with a small diameter catheter, and then under the influence of the pulse, small bubbles of vapor are formed, which affect the blood vessel wall. As a result, the affected vein becomes part of the tissue and no longer bothers the patient.
  • Endoscopic removal of the affected vein.In this case, insert the endoscope into the vein, and the doctor can personally analyze the condition and degree of damage. In the future, the surgeon can remove the affected area.

The so-called seamless technique is very popular when the affected part of the vein is removed through a small puncture incision. The patient can walk independently 4-6 hours after the operation. If the development of nutritional disorders is observed, use endoscopic equipment.

Advantages of minifibrectomy

Microphlebectomy for varicose veins

Microphlebectomy is one of the most painless and non-invasive methods for surgical removal of affected veins. The process is divided into three stages: diagnosis, making a small incision with a scalpel at the site of the blood flow disorder, and removing the vein in the affected area.

The operation is performed under local anesthesia, and the recovery period will not take up much time for the patient. The puncture site will not form scars or bruises, and in some cases, it will cause pain.

Mini sural resection is an almost painless way to get rid of varicose veins, and the recovery period after surgery is very small.

In order to minimize the risk of bruising and bruising, swelling anesthesia can be used for surgery. In addition to anesthetics, swelling anesthesia also contains substances that have vasoconstrictive effects. After the operation, the patient was discharged a few hours later without the characteristics of general anesthesia and painful poisoning.

Cross resection

Cross resection refers to the ligation of the great saphenous vein or the great saphenous vein and subsequent cross section. As an independent operation, this operation can only be performed in emergency situations where there is a risk of spreading acute thrombosis.

Nowadays, there are more benign alternatives to crossover surgery-intravascular laser ablation and radiofrequency ablation.

The advantages of this technology are: the ability to reject general anesthesia, outpatient treatment, and there are no cosmetic defects in the form of incisions and scars.

Disadvantages include the higher likelihood of disease recurrence and the higher cost of these procedures.

Preparation

Varicose vein surgery of the lower extremities is performed after preliminary examination of the patient and internal examination.

The following inspection types can be assigned:

  • Perform an ultrasound examination of the leg veins.
  • Complete blood count.

In the future, doctors will perform oral examinations to determine possible surgical contraindications. The preliminary examination allows you to choose the best type of surgery or to combine multiple known techniques immediately if necessary.

Before and after surgery, it is very important for patients to understand how to do things right. Before surgery, due to the risk of bleeding, it is recommended not to take drugs including aspirin. On the day of the operation, there is no need to prepare for the operation very carefully-you only need to remove the hair from the limb area being operated on.

When does the operation need to be performed

Indications for varicose vein surgery

Patients who want to know whether lower extremity varicose veins require surgery should understand that this thorough treatment must be used in the following situations:

    The disease progresses rapidly, accompanied by severe pain syndrome.
  • The development of grade 1-4 varicose vein thrombophlebitis.
  • A strong feeling of heat and vein burning.
  • Varicose veins spread above the kneecap.
  • Visible swollen, aesthetically unattractive veins.

This surgery is also used to form long-term incurable nutritional disorders (ulcers), and conservative treatments are not effective.

Contraindications and possible consequences

Possible contraindications and surgical consequences must be considered.

If the patient has a history of high blood pressure, abnormal heart rhythm, coronary heart disease, infectious diseases in the acute stage, and inflammatory diseases of the leg skin, surgical intervention cannot be performed.

Surgery should not be performed in the third trimester of pregnancy and elderly patients with weakened immune systems.

Preventing contraindications for varicose vein surgery

Patients should consider possible complications and consequences of surgery:

  • Due to damage to nerve endings, sensory disturbances in the operated limbs.
  • Periodic or persistent numbness in the ankle area.
  • The formation of suppuration.
  • Bleeding of varying degrees occurred.
  • The raised veins above or below the scar re-form after surgery.
  • Pain syndrome does not bother all patients and can occur if nerve endings are affected. In most cases, sensitivity can be normalized without the use of any drugs.
  • Hematomas and bruises at the surgical site can be disturbing. In this case, a topical anticoagulant can be prescribed. If the patient’s skin is very sensitive and delicate, the bruising marks will last for 1-1. 5 months.
  • The development of edema may indicate that the patient did not follow the doctor's instructions, did not observe the rest regime and exposed the body (including the lower limbs) to excessive physical exertion.

Strictly follow the doctor’s advice, depending on how quickly the consequences of the operation are.

Therefore, before deciding whether to operate on varicose veins in the legs, all possible risk factors should be considered: weigh the pros and cons. If the manifestations of the disease bother the patient for a long time and seriously impair the quality of life, surgery should be performed.

It is also necessary to consult only experienced and qualified doctors who perform such operations: venous hematologists, vascular surgeons.

Recovery period

Rehabilitation after varicose vein removal

After the operation, it is recommended that the patient follow all the instructions of the attending doctor to minimize the time spent in the recovery period and quickly return to a normal lifestyle. During the first 48 hours, patients are strictly prohibited:

  • Drink alcoholic beverages.
  • Automobile transportation management.
  • Bathe in the hot tub.
  • Excessive physical exercise.

In the first few days after the operation, symptoms of leg pain and increased body temperature may occur. In this case, medication should be used, and physical therapy should be performed. The patient does not have to be in a horizontal position all the time. You should walk a little bit every day to restore blood flow.

In the future, the implementation of the following recommendations will also minimize the risk of postoperative complications listed.

  1. Hydrotherapy, massage, remedial gymnastics and other physical therapy methods prescribed by the attending doctor. Such a procedure prevents the formation of blood clots and normalizes blood flow.
  2. In the first few months, special stretch underwear or compression socks are required to re-wrap the limbs.
  3. Use plant protection medicine, vascular protection medicine. As the inflammatory process develops, antibacterial drugs can be prescribed. Analgesics are used to relieve pain.
  4. Compression underwear to remove varicose veins after surgery
  5. If stitches have been placed, they can be removed 7 days after surgery.
  6. If the patient is overweight, he should return to normal to reduce the load on the veins.
  7. It is recommended to give priority to using loose clothes and comfortable shoes made of natural fabrics. Don't wear high heels.
  8. At home, try using a pillow or pillow to raise your legs.

The recovery period may be as long as several weeks, during which time special sick leave will be granted to patients.

Modern methods of removing varicose veins only require a few days of recovery, but they are more expensive than usual.

In the future, patients will have to visit the clinic for a second examination and undergo other examinations so that the doctor can evaluate the effectiveness of the treatment.

Operating costs

Vein extractions have been performed at the National Clinic and Plastic Surgery Center to eliminate aesthetic defects.

The patient is very interested in the cost of varicose vein surgery.

It all depends on the qualifications of the clinic and the doctor performing the procedure, as well as the degree of disease progression and the complexity of the proposed surgery.

Expert predictions

Expert prognosis after varicose vein removal

Combined vein resection cannot rule out the possibility of disease recurrence. After a thorough treatment, varicose veins may recur due to the physical characteristics of the body (the structure of blood vessels and veins) or the conditions for performing the surgical technique (if the doctor cannot restore the patency of the affected veins to normal). The risk of further deterioration of the disease is observed in approximately 15% to 20% of cases. If the patient notices recurrent episodes of the disease, he should consult a doctor as soon as possible.

Only experienced experts can help you correctly recommend which surgery to choose to remove varicose veins, and will also provide useful advice to follow during your recovery. If you do not consult a doctor in time, the consequences may be the most tragic and irreversible.

03.12.2020