If the first stage of varicose veins is treated very effectively with conservative methods, then the progression of the disease in stages 2 and 3 can only be treated with surgery, 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 peculiarities of their application and so on.
Indications for surgery
Due to the fact that in the early stages of varicose vein surgery, surgery is extremely rare due to lack of need, a very important factor is the indication for surgery. The decision is based on the data obtained during the detailed diagnosis of blood vessels and is taken by the patient together with the doctor.
A venologist is obliged to tell about the risks of the proposed surgery, the duration and the nuances of the rehabilitation after surgery, which are then carried out only with the consent of the patient.Regarding the indications themselves, varicose vein surgery is required in such cases:
- Pathological dilation and subsequent deformity of clear veins of the second degree of severity and above. Extensive forms of varicose veins, the disease affects not only the saphenous veins, but especially the deep veins, or the deformation of the vessels extends to too many of the lower extremities.
- There is a serious circulatory disorder accompanied by worsening blood clots.
- Severe forms of swelling, high-intensity pain syndrome, accompanied by distinct external (aesthetic) signs of varicose veins.
- Formation of trophic ulcers on the skin or subcutaneous hematomas due to reduced vascular integrity.
- Progression of the pathological process until the occlusion of the venous vessels and the development of an acute form of thrombophlebitis.
- Lack of positive dynamics during conservative treatment, ie when medications and other methods of treating varicose veins are powerless.
Limitations and contraindications for operation
Unfortunately, even with the onset of severe varicose veins, accompanied by complications and a severe clinical picture, it is not always possible for a patient to undergo surgery.There are some contraindications, which, if they do not completely rule out the possibility of surgery, make it necessary to postpone the operation for a certain period of time:
- Ischemic heart disease - in this case, it is necessary to perform a more comprehensive and integrated examination.
- The same goes for grade 3 hypertension.
- Active infectious and inflammatory processes in the body - before performing a surgery to treat varicose veins, you must treat the infection or eliminate the inflammation.
- 2nd and 3rd trimester of pregnancy - for pregnant women, it is better to postpone any surgery until the woman gives birth. The only exceptions are cases where there is a serious risk to the life of the mother or child and surgery can help.
- Skin disease in the area of the operation to fight varicose veins. We are talking about eczema, various forms of dermatitis and so on.
- There are also some age restrictions, of course, for the elderly. In some cases, aging, as well as the accompanying senile diseases, increase the risk of postoperative complications or endanger a person's life at the operating table.
Varicose vein surgery methods
However, if the doctor, based on the diagnostics and after the examination of the patient, is sure of the need for surgery, the choice of the most appropriate and effective method remains, depending on the degree of development of varicose veins and certain other factors. . To understand what surgeries are and in what cases they are performed, we will look at the most effective methods of surgical treatment of varicose veins.Combined phlebectomy
A complete operation performed under general anesthesia and can take up to 2 hours, depending on the complexity of the task. Phlebectomy can be used to treat the initial forms of varicose veins, but more often this method is used in advanced cases when the disease has progressed severely.
During the operation, the surgeon makes an incision up to 2 cm in length for the ankle or up to 5 cm for a wider area such as the groin. Often, these incisions are shallow, as most of the superficial veins are removed.
The beginning of the operation is the ligation of the anastomosis of the vessel with the subsequent removal of the part of the vein that is 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, cosmetic sutures are applied to the incisions, a bandage is applied and an elastic bandage is applied to the surgical site to prevent bleeding.
Miniflebectomy
During this procedure, the affected area of the vein is also resected, however, the scale of the operation is smaller, it can probably be considered purely cosmetic. The point is that the doctor makes a small puncture in the skin, through which he removes a part of the vein that needs to be cut. This operation is performed mainly on small vessels, and its advantages are the pain (due to local anesthesia) and the minimal recovery period.
Sclerotherapy
A relatively new technique, a minimally invasive method, which is famous for its effectiveness, as well as the absence of painful sensations due to the same local anesthesia and virtually no recovery period.
The procedure involves the introduction of a special substance into the lumen of the vein - a foam hardener. This substance leads to the collapse of the vessel walls with their subsequent adhesion. As a result, the vein ceases to be involved in the blood circulation process, gradually receding and being replaced by connective tissue.
The method of sclerotherapy is mainly used to eliminate small superficial vessels, as well as to get rid of the so-called "spider veins".
Laser coagulation
The most modern and, according to many experts, an effective way to treat varicose veins. Its essence lies in the fact that a laser light guide is inserted into the venous lumen through an opening of only 2 mm. When the latter is activated, it starts emitting laser waves, the temperature rises inside the container and as the laser is removed, the walls of the veins collapse and stick together. The container then disappears on its own, being replaced by connective tissue.
Of course, the main advantage of this procedure is the almost complete absence of visible damage to the skin, as well as the absence of the need for a recovery period.
Possible consequences
Even the mildest operation leaves traces and can have consequences. First of all, this is due to the fact that the anatomical component of the body is removed - a complete vessel. Of course, with combined phlebectomy, such consequences can be much more serious than a few bruises after laser coagulation.
Let's look at the most basic consequences that occur periodically after a particular type of surgical treatment:
- There is a risk of recurrence when removing varicose veins using minimally invasive methods, excluding vascular removal. This risk is minimal only during laser coagulation, only 5%.
- Burns - occur after work in which thermal effects have been applied. Bleeding - can start after any type of intervention, but more likely after a phlebectomy.
- There are also known cases of nerve damage, but this factor refers exclusively to the level of professionalism of the surgeon.
Recovery process
Rehabilitation is required, ie rehabilitation after surgery, in each of the cases described, but if after coagulation this procedure lasts only a few days, then after combined phlebotomy it may take several weeks. For a smooth and quick recovery, it is important to follow simple recommendations:
- Follow your doctor's advice carefully.
- Wear compression garments or elastic bandages.
- If incisions have occurred, it is important to wait for them to heal.
- Once the incisions have healed, it is important to restore physical activity, exercise and regular walking will help.
- If your doctor prescribes any medicine, take it according to these instructions.
- It is also helpful to visit a masseur after surgery and to prevent varicose veins.
- Do not engage in strenuous physical activity for at least 2-3 months.
If the surgery went well and the patient fully followed the doctor's instructions for recovery, the chance of a favorable outcome is very high. In most cases, varicose veins can be cured, but this does not mean that the disease can not affect other blood vessels. For this reason, the prevention of varicose veins should always be carried out if there have been cases of development of this pathology.