Varices on surgical legs of the legs

For many decades, surgical treatment of varicose veins of legs remains the only radical method of eliminating this disease and its complications.Thanks to modern technologies and the improvement of operating techniques, it is really effective both in therapeutic and cosmetic terms, it is carried out as easily and without pain as possible, well tolerated by patients and does not cause prolonged handicap.

Normally, around 30% of the blood of the lower limbs flows through small subcutaneous venous tributaries, which merge in two central venous trunks-a large and small subcutaneous vein.These ships are directly linked to the deep veins, through which 70% of the blood circulates.In the places of such compounds, there are valves which pass blood only from the veins of deep surface.There are also dozens of small veins, also connecting the superficial venous network with Deep.They also have valves that do not transmit blood in one direction.The main cause of varicose veins is the failure of the venous valves, which leads to poor blood listening: deep veins on the surface, which increases the pressure and causes the expansion of the small vessels and central venous trunks.The main objectives for which surgical treatment is intended for varicose veins of the lower limbs:

• The elimination of the stagnation of blood in the altered surface veins of the legs, which will prevent the progression of chronic venous insufficiency and trophic disorders on the skin.
• Elimination of distorted vessels and varieties representing a cosmetic defect.
• The elimination of the flow of the blood of the deep veins in superficial veins - the ligation and the intersection of the perforating veins (clans), as well as large and small subcutaneous veins in the places of their connection with the deep.
• Prevention of a repeated occurrence of varicose veins.

A separate place in the surgical treatment of female varicose veins of the lower limbs belongs to cosmetic surgery.After such interventions, not only the pathologically modified veins, but also the postoperative scars on the skin of the legs, or they are discreet.To obtain the maximum aesthetic effect, surgery for varicose veins is carried out according to the following methods:

• Ablation to the laser or the radiofrequency of the veins which burn the central trunks of a large and small subcutaneous vein under the control of the ultrasound by a puncture of the skin on the thigh or on the foot.
• Scleroticing of stems and sclerotherapy - filling large and small subcutaneous veins, as well as all their tributaries, even the smallest, with a special medication.

With one of the treatment methods described, the varicose veins are not eliminated, but are transformed blood vessels into gentle scar fabric.The two physical influences (laser rays, radiofrequency waves) and chemical (sclerosing) compounds destroy the inner layer of the vein.Thanks to this, he loses the light, the coges and the desolate completely of the blood, turning into ordinary connective tissue (scar).Thus, without direct elimination of the veins, all the objectives which are assigned to the rapid treatment of the varicose veins of the lower limbs are achieved - the modified vessels are eliminated and the dangerous consequences of venous insufficiency are eliminated in them.The only restriction of cosmetic operations in the treatment of varicose veins in women is only possible veins slightly or limited to 1 to 2 degrees.During pregnancy and at the start of the postpartum period, surgical treatment is contraindicated with the exception of acute situations requiring emergency intervention, for example, with an ascending thrombophlebitis.The operation is limited to the dressing of a large subcutaneous vein instead of its connection with the femoral (crosscomy).Consider the most common surgical interventions in the treatment of varicose veins of the lower limbs: laser removal, endoscopic dissection of the veins and phleectomy.The latter is divided into the following types:

• Classic operation, or complete stripping or operation of Trojanov-Trendelenburg-Bubko-Narata;
• short stripping;
• Flebectomy.

Fubletomy

Elimination, the extraction of the veins under the skin is called phleectomy.This is one of the first methods of surgical treatment for varicose veins of the lower limbs.But even today, phleectomy is most often carried out by phlebology and vascular surgeons.There are three operating modifications and methods: complete and short stripping, miniflectomy.Domestic surgeons call for classic phleagentomy The Trojanov-Trendelenburg-Bubko-Narat operation and foreign authors with complete stripping.The intervention volume is presented:

1. As a trunk bandage of a large subcutaneous vein in place of its confluence, 2-3 cm on the thigh under the inguinal fold, in the thigh, by an incision.
2. Its removal throughout the groin at the foot using a special probe through two sections of the skin 1 to 2 cm along the inner surface near the knee and ankle.
3. The elimination of all varicose veins and small veins by small separate incisions is approximately 1 to 2 cm (they can be 5-6 to 10-20) with the dressing of insolvent perforating vessels.
4. Couture all injuries with cosmetic seams.

Classic phleectomy allows you to delete varicose veins, but the most traumatic among all existing techniques.

Short stripping

With a short stripping, not all the large subcutaneous vein is removed, but only its fragments, affected by varicose veins, for example, only on the thigh or on the bottom of the leg.The healthy segments have not been deleted.This reduces the trauma of the intervention, but the risk of relapse of the disease remains.Otherwise, the operational operations of the operation are similar to classic phleectomy.

Fubletomy

The innovative methodology foreliminating small varicose veins from a large subcutaneous vein is called phleectomy.For its implementation, special tools (pointed scalpel, hooks, pliers, spatula) are necessary, with which the veins are extracted through the skin of the skin of several millimeters.It is not necessary to sew these skin defects, the scars are invisible.Most often, surgeons combine a short or complete stripping of a large subcutaneous phlectomy vein.Such a combined operation combines radicalism and adhesive trauma with a good cosmetic effect.Laser removal for varicose veins involves burning with a laser beam of a large subcutaneous vein everywhere on the side of its clearance.To do this, by puncturing the skin on the thigh or in the ankle area in the light of the vein, a cattle vertigo is presented over its entire length.Under the control of ultrasound, the Svetivod is slowly extracted.The laser beam, acting on the venous wall, destroys the inner layer.As a result, Vienna falls and stops working, which is clearly visible on the ultrasonic instructor.If not only is the main venous trunk affected by varicose veins, but also its tributaries, they are deleted according to the method of phleectomy.

A disease such as varicose veins is a disease characterized by a dysfunction of the vascular walls and the weakness of the valves in the veins, which causes stagnation in the blood vessels of the lower limbs and the appearance of venous nodes.Such a pathology is quite dangerous and loaded not only with trophic disorders and the presence of an inflammatory process, but also by the lack of tissue nutrition.As a rule, this contributes to the formation of blood clots, which can spread through blood flow through the whole body and the appearance of trophic ulcers that are difficult to live in.In addition, the formation of thrombotic inside the vessels threatens the development of such a disease as thrombophlebititis.Consequently, if the patient has varicose veins of the lower limbs, surgical treatment is compulsory, especially if the disease is launched.I would like to attract the attention of the readers of our site that surgery for the varicose veins of the lower limbs is a radical measure and, as a rule, is prescribed if it cannot do without it.Varic disease of lower limbs, surgical treatment involves several, the most used in surgical practice options for surgical treatment.These options are directly in the approach to the elimination of ships and veins affected by the lower limbs.

• The use of traditional phleectomy in surgical practice for the radical treatment of varicose veins.This option is made in accordance with the Bebbok methodology.This implies the introduction of a probe specially designed for such a procedure in the light of the ship and the subsequent extract of the vein by a pre-made incision on the skin.After the operation, his cord is made with a cosmetic seam, which makes it almost invisible.
• Flébectomy - Such an operation is necessary to eliminate small sections of blood vessels and veins, affected by varicose veins.Note that this operation does not provide for cuts on the skin, because part of the assigned ship or vein is removed by puncture on the skin, which does not require imposing seams.

Note that surgery in the treatment of certain diseases is displayed far.However, varicose veins of the lower limbs, surgical treatment is extremely necessary if the elimination of blood clots and potentially dangerous sources of the inflammatory process is necessary.This approach will improve the patient's condition and help avoid severe and unsafe complications for the health and life of patient complications.States requiring urgent surgery for varicose veins include:

• the presence of thrombophlebitis or the risks causing its appearance;
• Acute thrombophlebit or frequent exacerbations of the disease;
• A great defeat of blood vessels and veins;
• The constant sensation of fatigue and constant severity in the legs, unpleasant pain, which indicates a clearly expressed varicose vein;
• The appearance of trophic ulcers.

There are also certain contraindications to the operation for varicose veins:

• second and third quarter of pregnancy;
• the presence of infectious diseases in an acute form;
• exacerbation of pathologies existing in a patient (diabetes, asthma, gastroduodenal ulcer and others);
• myocardial infarction, stroke;
• Dermatological problems.

Tellard - As a rule, this method is used in the presence of a small section of the lesion, it is a more saving technique, unlike traditional phleectomy.The method is to stretch, through a special hook, the most venous knot.There is also a subspecies of this technique - Cryostroping, which involves the sinking of the damaged ship in Cryosonda and its subsequent withdrawal.

SCLERROSE - The technique provides for the introduction of a damaged sclerosing, a special substance for the "collage" of the ship walls between them.Nevertheless, after the procedure, the vein does not stretch, but remains in place, without fulfilling its objective, although the blood flow across the Vienna and stops, however, this function is fulfilled by the collateral vessels, which does not violate the flow of venous blood.The operation is carried out under the compulsory control of a specialist with ultrasonic equipment.

Laser coagulation - This method is the most innovative in the treatment of varicose veins and is the introduction of special equipment with laser radiation (thin probe) in the light of the vein.The device has a cauterizing effect on the walls of the blood vessel.

Consequences after surgery to eliminate varicose veins:

• The appearance of characteristic postoperative hematomas on the surface of the body, which, as a rule, are resolved for several months;
• In addition, after several months, seals under the skin along the bed of the distant ship disappear;
• Violations of the integrity of the lymphatic system (blood vessels) of blood vessels, which can cause stagnant processes.These postoperative consequences are treated in a conservative manner, however, often the circulation of the lymph is restored after a few months;
• Possible damage to the terminations of the subcutaneous nerve, which manifests itself by an altered sensitivity of the epidermis - this postoperative symptoms passes after 5 to 6 weeks.

To summarize

Varicose disease surgery

Traditionally, phleectomy (worship) is carried out as a function of the Bebcock method and consists in introducing the probe into the light of the vein with the subsequent stretch of the vein completely on its length through the cut outside of the skin.The incision is sutured at the end of the operation with a cosmetic seam.Flebectomy is used to eliminate the very short areas of the vein, during the operation, the veins are not used.The cuts on the skin are not made and a piece of vein is removed by a thin bite from the skin which does not require imposing seams.With a small area of damage to varicose veins, it is possible to perform a softer technique - stripping.This extends with a thin hook of a varicose node.The experience is carried out by means of two cuts on the skin with their subsequent suture.A variety of this technique is cryostroping - "pour" from the vein to the cryosonda using low temperatures, the destructive node is also stretched.

Vienna's sclerosion is the introduction of a sclerosing in its light - a substance that "sticks" the walls of the vein with each other, but the vein remains deep under the skin, not performing its functions.The blood flow through the vein stops and goes through collateral vessels, without violating the flow of the venous blood of the lower limb.Vienna sclerosis is carried out under the control of ultrasound.Laser coagulation of varicose veins is the last method of phlebology and consists in introducing a thin probe in the light of the vein with a laser radiation, which exerts a cauterizing effect on the walls of the vein.The radio frequency method exposing the veins also refers to a more modern treatment of varicose veins, but not all medical institutions are equipped with appropriate equipment.The technique consists of the "cauterizing" effect on the vascular wall of high frequency radio waves.