Types of surgery to remove varicose veins and possible consequences

Varicose veins or varicose veins, these formulations in phlebology indicate pathology accompanied by modification, or deformation of veins.The vessels that carry blood to the heart expand, lengthen, their walls become thinner, and the work of the venous valves is disturbed.

If the first stage of varicose veins is very effectively treated with conservative methods, then the progression of the disease to stage 2 and 3 can only be cured surgically;drugs and other methods can only stop the progression of the pathology.This article will discuss the main surgical methods for the treatment of varicose veins, the features of their application, and so on.

Indications for surgery

Given that in the first stage of the development of varicose veins, surgical intervention is performed extremely rarely due to the lack of need, indications for surgery are a very important factor.The decision is based on the data obtained during a detailed vascular diagnosis and is made by the patient together with the doctor.

The phlebologist is obliged to talk about the risks of the proposed operation, the duration and nuances of rehabilitation after the operation, which are subsequently carried out only with the patient's consent.

As for the indications themselves, varicose vein surgery is required in the following cases:

• Pathological expansion and subsequent deformation of purely saphenous veins of the second degree of severity and more.
• Extensive forms of varicose veins, the disease affects not only subcutaneous, but mostly deep veins, or the deformation of blood vessels spreads to an excessive area of the lower extremities.
• There is a serious circulatory disorder, accompanied by worsening blood stagnation.
• Severe forms of swelling, intense pain, accompanied by distinct external (aesthetic) signs of varicose veins.
• Formation of trophic ulcers on the skin or subcutaneous hematomas due to violation of the integrity of blood vessels;
• The progression of the pathological process until the blockage of venous vessels and the development of an acute form of thrombophlebitis.
• Lack of positive dynamics during conservative treatment, i.e. when drugs and other methods of combating varicose veins are powerless.

Limitations and contraindications for surgery

Unfortunately, even if severe forms of varicose veins develop, accompanied by complications and a difficult clinical picture, the patient cannot always undergo surgery.

There are a number of contraindications that, even if they do not completely exclude the possibility of surgical intervention, still force a person to postpone the operation for a certain time:

• Coronary heart disease - in this case it is necessary to conduct a more complete comprehensive examination.
• The same applies to hypertension of the 3rd degree.
• Active infectious and inflammatory processes in the body - before performing surgery for the treatment of varicose veins, you must deal with the infection or remove the inflammation.
• 2nd and 3rd trimester of pregnancy - it is better for pregnant women to postpone any surgical procedures until delivery.The only exceptions are those cases when there is a serious danger to the life of the mother or the child, and surgery can help.
• Skin diseases in the area of surgery to combat varicose veins.We are talking about eczema, various forms of dermatosis, etc.
• There are also certain age restrictions, of course for the elderly.In some cases, older age, as well as accompanying senile diseases, increase the risk of developing postoperative complications or endanger the life of a person on the operating table.

Methods of surgical intervention for varicose veins

If, however, based on the diagnosis and after examining the patient, the doctor is convinced of the need for surgical intervention, all that remains is to choose the most suitable and effective method, depending on the degree of progression of varicose veins and a number of other factors.In order to understand what operations exist and in what cases they are performed, we will consider the most effective methods of surgical treatment of varicose veins.

Combined phlebectomy

A full-fledged operation that is performed under general anesthesia and can last up to 2 hours, depending on the complexity of the task.Phlebectomy can be used to treat initial forms of varicose veins, but this method is more often used in advanced cases when the disease has progressed severely.

During the operation, the surgeon makes an incision up to 2 centimeters long if the operation is performed in the area of the ankle joint, or up to 5 centimeters when operating on a larger area, for example, in the groin.Often these incisions are shallow, as superficial veins are mostly removed.

The principle of the operation is to ligate the anastomosis of the vessel, and then remove the part of the vein affected by varicose veins.Also, during surgery, the surgeon can correct the venous valves to restore normal blood flow.

At the end of the operation, aesthetic sutures are placed on the incisions, a bandage is made, and an elastic bandage is placed on the operated area to prevent bleeding.

Miniphlebectomy

During this procedure, the affected area of the vein is also excised, however, the scope of the operation is smaller and can rather be considered purely cosmetic.The idea is that the doctor makes a small puncture in the skin, through which he pulls out the part of the vein that needs to be cut.This operation is performed mainly on small vessels, and its advantages are painlessness (due to local anesthesia) and a minimal recovery period.

Sclerotherapy

A relatively new technique, a minimally invasive method, which is known for its effectiveness, as well as for the absence of pain due to the same local anesthesia and the practically non-existent rehabilitation period.

The procedure involves the introduction of a special substance into the lumen of the vein - a foam sclerosant.This substance causes the walls of the vessel to collapse by their subsequent sticking.As a result, the vein ceases to participate in the process of blood circulation, gradually dissolves and is replaced by connective tissue.

The sclerotherapy technique is used primarily for the removal of small surface vessels, as well as for the removal of so-called "spider veins".

Laser coagulation

The most modern and, according to many experts, effective way to fight varicose veins.Its essence lies in the fact that the laser light guide is inserted into the vein lumen through a hole of only 2 millimeters.When the latter is activated, it starts emitting laser waves, the temperature inside the vessel rises, and as the laser is removed, the walls of the vein collapse and stick together.After that, the vessel itself disappears and is replaced by connective tissue.

Of course, the main advantage of this procedure is the almost complete absence of visible skin damage, as well as the absence of the need for a rehabilitation period.

Possible consequences

Even the most gentle operation leaves certain traces and can lead to consequences.First of all, this is due to the fact that an anatomical component of the body is removed - a full-fledged vessel.Of course, with combined phlebectomy, such consequences can be much more serious than a few bruises after laser coagulation.

Let's consider the most basic consequences that occasionally arise after one or another type of surgical treatment:

1. When removing varicose veins using minimally invasive methods that exclude the removal of blood vessels, there is a risk of recurrence.This risk is minimal during laser coagulation, only 5%.
2. Burns - occur after operations during which thermal effects were used.
3. Bleeding – can start after any type of intervention, but is more likely after phlebectomy.
4. Cases of nerve damage are also known, but this factor relates exclusively to the level of professionalism of the surgeon.

Rehabilitation process

Rehabilitation, i.e. recovery after surgery, is necessary in each of the described cases, but if after coagulation that process lasts only a few days, then after combined phlebectomy it can last several weeks.In order for the recovery to go smoothly and quickly, it is important to follow simple recommendations:

1. Strictly follow all doctor's advice.
2. Wear a compression suit or elastic bandages.
3. If there were cuts, it is important to wait for them to heal.
4. After the incisions have healed, it is important to resume physical activity;exercise and regular walks will help with this.
5. If your doctor prescribes any medication, take it as directed.
6. It is also beneficial to see a massage therapist after surgery to prevent varicose veins.
7. You should not be exposed to serious physical activity for at least 2-3 months.

If the operation went well and the patient fully followed all the doctor's instructions regarding recovery, the probability of a favorable outcome is very high.In most cases, varicose veins can be cured, but this does not mean that the disease cannot affect other blood vessels.For this reason, prevention of varicose veins should always be carried out if there have been cases of the development of this pathology.