Choosing the best way to treat varicose veins is an urgent problem faced by patients and venologists. In the early stages of the development of the pathology, mainly conservative methods of treatment are used, which make it possible to maintain the varicose veins. However, if such a technique proves ineffective, the only appropriate option that can change the situation for the better is surgery to remove leg veins. Surgery is the most radical method of treating varicose veins, as the remote areas of damaged blood vessels simply cannot change the varicose veins again.
In this article, we will look at the types of varicose vein removal surgeries that modern vascular surgery can offer: their features, their advantages and disadvantages, their preparation and application features, and their recovery and possible complications.
What can be achieved with leg vein surgery?
Varicose vein surgery aims to solve the following problems:
- Elimination of reflux - abnormal reflux caused by venous valve insufficiency.
- Varicose vein removal. It is recommended if the vein has undergone severe transformation and there is no hope of restoring normal blood flow to it. In this case, the part of the vessel that affected the varicose veins is removed and the blood from it is redistributed through healthy veins.
- Combating cosmetic defects. Since CVI (chronic venous insufficiency) and the varicose veins caused by it do not change the appearance of the lower extremities in the best way, the operation should aim, among other things, to eliminate aesthetic defects.
Types of venous surgery
The types of surgeries that modern vascular surgery can offer to fight varicose veins are divided into two groups:
- Companies that aim at the mechanical resection of the varicose veins that are affected by the varicose veins with their subsequent ligation.
- Interventions related to thermal or chemical exposure to varicose veins.
The choice of the most appropriate surgery on the vein of the foot depends on the stage of development of the pathology, the age and general health of the patient, as well as the goals pursued during the procedure.
Phlebectomy of the veins of the lower extremities: the course of the operation
Combined phlebectomy (phlebotomy) is the "gold standard" in the surgical practice of treating varicose veins.
This method aims to remove the dilated varicose veins.
The operation has several varieties, each of which is named after its inventor: phlebectomy according to Bebkokk, according to Narat, according to Mueller, which are performed under local (with extensive vascular lesions - under general)anesthesia.
Despite the differences, all these procedures for the removal of leg veins have one thing in common: they involve cuts or holes in the skin from 1 mm to 5-6 cm in length, through which the vascular surgeon pulls the affected vein to the surface using a specialhooks. The veins are cut, connected and removed, after which sutures or a special plaster is applied to the skin. This operation for the removal of varicose veins in the legs is extremely effective and allows you to achieve positive results in the treatment of venous pathology.
Laser vein surgery
With the development of medicine in the arsenal of vascular surgeons, more modern and less traumatic methods of performing an operation to remove veins began to appear compared to the classic surgical intervention. With their help, it is possible to reduce the time of the procedure, to minimize the postoperative scars and also to reduce the possibility of complications and side effects. One of these methods is laser surgery on the veins of the lower extremities (intravenous, intravascular or intravascular laser coagulation).
A special laser light guide is inserted into the cavity of the affected vessel, heating the wall of blood and vein. Under the influence of high temperatures up to 120 degrees, the walls of the vessel stick together, causing blood to stop flowing to this part of the circulatory system.
Expert opinion
Depending on the area of the lesion and the number of veins that need to be removed, treating varicose veins in this way usually requires several procedures lasting 30-60 minutes.
Laser vein removal surgery is of low trauma, gives a good cosmetic result (after that there are no visible scars and scars on the skin), does not require long-term hospitalization. However, it should be borne in mind that this technique is not suitable for treatment in the later stages of varicose veins, when the diameter of the veins is significantly increased and there are varicose veins; to eliminate them, traditional surgery will be needed.
Sclerotherapy
This is another modern vein removal surgery that allows you to achieve noticeable results with minimal trauma. A hardener is injected into the lumen of the dilated vessel - a special liquid or foam substance that sticks together the walls of the affected area of the vein. Performing a sclerotherapy course allows you to achieve a quick cosmetic result without scars, which makes it very popular. However, this procedure is only suitable for the initial stage of varicose veins, as well as for telangiectasias.
Radiofrequency venous surgery
RFA (radiofrequency ablation) is the effect on the affected areas of blood vessels with specific frequency radio signals, which lead to heating of the vein walls, destruction of the endothelium and consequent sealing of the vascular lumen. The procedure is minimally invasive and does not require hospitalization.
Preparing for vein surgery
Before surgery, it is necessary to carry out preparatory measures: ultrasound of the veins of the lower extremities, clinical blood test and coagulation. On the eve of the procedure, you should shave your foot without using creams, gels and other cosmetics.
Expert opinion
If general anesthesia is planned, you should abstain from food for 8 hours before the procedure (although in some cases your doctor may allow a light snack). Enema cleansing may also be required prior to general anesthesia.
Contraindications to leg vein surgery
These surgeries are not recommended during pregnancy, with severe endocrine and cardiovascular pathologies, in the exacerbation of chronic diseases, in the presence of infectious and inflammatory processes in the legs.
Recovery after venous surgery
The duration of the recovery period depends on the number of veins removed, the general health of the patient and his compliance with the recommendations of the venologist.
Usually, the recovery period lasts from 2 months to six months.
Depending on the type of surgery, limited activity may be suggested to the patient during the recovery period. 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 phlebectomy requires a certain amount of time to limit mobility.
Recommendations for rehabilitation after leg vein surgery
To reduce the risk of recurrence and complications after surgery, there are some limitations and recommendations that should be followed:
- You must wear knitwear with an appropriate level of compression. Tights or socks after venous surgery are a prerequisite for the normal restoration of blood flow to the lower extremities.
- Adjust the load on the legs. It is important to choose the "golden mean" here: not to allow both complete immobility and prolonged posture, sitting, running.
- Do not lift weights (during the recovery period, the maximum permissible weight is up to 5 kg).
- Do not take a hot bath, do not take a steam bath or sauna, avoid contact with the skin in the area of the distal veins of direct sunlight for some time.
- Wear baggy pants or skirts, avoid tight, uncomfortable shoes (especially heels).
- Take medicines prescribed by your doctor. Most often, the intake of phlebotonics, anticoagulants, antioxidants is prescribed.
Consequences and complications after venous surgery
Any surgery can have side effects and surgery on the veins of the lower extremities is no exception. Possible complications include the following:
- Varicose veins recurrences. If the underlying cause of varicose veins is not eliminated, chances are high that the disease will come back. Therefore, in addition to surgery on the veins of the legs, it is necessary to carry out a comprehensive treatment of the pathology and eliminate the provoking factors.
- The rise in temperature. A slight increase in local temperature in the area of the removed veins is normal in the postoperative period. Also, for 1-2 days after the end of the procedure, the total body temperature may remain at non-fat levels.
- Hematomas. Bruises after venous surgery are a common complication after venous removal. It is caused by perforation of the vessel. Small bruises usually go away without further treatment within a few weeks. However, if you have a large, painful bruise that does not go away in about 2 weeks, report it to your venologist.
- Staining disorders. The discoloration of the skin at the site of surgery usually persists for several weeks and then subsides. It should be borne in mind that hyperpigmentation is a very common complication after sclerotherapy.
To avoid these unpleasant phenomena, do not neglect the medical recommendations, be sure to wear compression tights and take medications recommended by the venologist.