What operations to eliminate varicose veins are most effective

The removal of the veins of the lower extremities is called a radical method of treatment. An operation to remove varicose veins in the legs can be prescribed to the patient if the use of conservative and alternative methods of treatment does not have the appropriate therapeutic effect and the disease continues to progress.

With the advanced form of varicose veins, surgery can solve the following problems:

• Eliminate pathological reflux (reverse flow) of blood.
• Preserve healthy, disease-free sections of the saphenous veins.
• Eliminate the affected areas of the veins.

Before the operation, the doctor marks the veins under ultrasound control, which makes it possible to determine the extent of the affected segment. The removal of affected vessels and sections of the vein is carried out using a narrow probe, which is inserted through a small incision. Once the affected area is removed, the risk of recurrence of the disease is low.

After surgery to remove a varicose vein, the risk of disease recurrence is low.

In modern medicine, they prefer the combined phlebectomy procedure, which involves the use of several techniques at once.

The main stages of the combined radical treatment are: high or low crossectomy, short stripping, perforating vein ligation, mini-phlebectomy.

In the early stages of the disease, one of the listed procedures can be used as an independent operation. In some cases, as an alternative to certain steps of the classic combined phlebectomy, minimally invasive treatment methods in the form of sclerotherapy or laser obliteration may be offered.

Types of operations

The general name for the operation to remove the affected veins is phlebectomy. Modern types of this procedure:

• The implementation of the stripping procedure (long or short) is the most gentle technique, during which the doctor can remove only a certain part of the affected vein. The procedure is performed through a small incision along the vein.
• The implementation of laser phlebectomy is a modern method of treatment that involves the use of a laser. Thanks to this tool, the laser coagulation process takes place inside the affected vessels. The procedure is performed under local anesthesia and does not require the use of special surgical instruments. The laser is injected into the vein with a catheter of small diameter, then under the influence of the pulse small vapor bubbles are formed, which affect the walls of the vessels. As a result, the affected vein becomes part of the tissue and no longer bothers the patient.
• Endoscopic excision of the affected vein. In this case, an endoscope is inserted into the venous area, and the doctor can personally analyze its condition and degree of damage. In the future, the surgeon has the option of cutting the affected area.

So-called seamless technologies are very popular, when the affected area of the vein is excised through small point incisions. Already 4-6 hours after the manipulation, the patient can walk independently. In the event that the development of trophic disorders is observed, endoscopic equipment is used.

The advantage of the miniphlebectomy method

Miniphlebectomy is one of the most painless and least traumatic methods of surgical removal of affected veins. The procedure takes place in three stages: diagnosis, small incision with a scalpel at the site of impaired blood circulation, extraction of the affected area from the vein.

The operation is performed under local anesthesia, the rehabilitation period does not take the patient much time. Scars, bruises do not form at the puncture site, pain is disturbed in isolated cases.

Miniphlebectomy is an almost painless way to get rid of varicose veins, the recovery period after the operation is minimal.

In order to minimize the risk of bruising and bruising, the operation can be performed using tumescent anesthesia, which, in addition to anesthetic, includes a substance with a vasoconstrictor effect. After the procedure, the patient is discharged after a few hours, while there is no intoxication characteristic of general anesthesia, and no pain.

Crossectomy

The concept of "crossectomy" means the ligation and subsequent crossing of a small or large saphenous vein. As an independent operation, such a procedure can be performed only in an emergency, when there is a risk of spreading an acute form of thrombosis.

To date, there are alternative, gentler procedures for crossectomy - performing endovascular laser ablation and radiofrequency ablation.

The advantages of the techniques are: the ability to refuse general anesthesia, outpatient treatment, the absence of cosmetic defects in the form of scars from incisions and scars.

Of the minuses, one can note a higher probability of recurrence of the disease and a rather high cost of such procedures.

Coaching

The operation for varicose veins of the lower extremities is carried out after a preliminary examination of the patient and the establishment of an internal examination.

The following exam types can be assigned:

• Ultrasound of the veins of the legs.
• General blood test.

In the future, the doctor will conduct an oral survey to identify possible contraindications to surgery. A preliminary examination allows you to choose the optimal type of surgical intervention or, if necessary, to combine several well-known methods at once.

It is very important that the patient understands how to behave properly before and after the procedure. Prior to surgery, it is recommended to refrain from taking medications, including acetylsalicylic acid, due to the risk of bleeding. On the day of the operation, it is not necessary to prepare particularly carefully for the procedure - it is enough to get rid of hair in the area of the operated limb.

When is an operation necessary?

Patients who wonder if surgery is necessary for varicose veins of the lower extremities should understand that such a drastic method of treatment is necessary in the following cases:

• The rapid progression of the disease, which is accompanied by severe pain.
• The development of varicose thrombophlebitis from 1 to 4 degrees.
• Sensation of intense heat and burning in the region of the veins.
• The spread of varicose veins above the kneecaps.
• Visible formation of a swollen vein, aesthetically unsightly.

The operation is also indicated for the formation of long-term non-healing trophic disorders (ulcers), for which conservative treatment does not have the appropriate therapeutic effect.

Contraindications and possible consequences

It is mandatory to take into account possible contraindications and consequences of surgical intervention.

Surgical intervention cannot be performed if the patient has a history of diseases such as hypertension, heart rhythm disorders, coronary heart disease, the presence of infectious diseases in the acute stage, dermatological inflammatory diseases of the legs.

The operation should not be performed at the end of pregnancy, or in elderly patients with weakened immunity.

Patients should consider possible complications, as well as consequences of surgery:

• Violation of the sensitivity of the operated limb as a result of damage to the nerve endings.
• Intermittent or persistent numbness in the ankle area.
• The formation of suppuration.
• The development of bleeding of varying intensity.
• Rehabilitation of bulging veins at a location above or below postoperative scars.
• Pain syndrome does not bother all patients and occurs if the nerve endings have been affected. Normalization of sensitivity in most cases occurs independently, without the use of drugs.
• Hematomas and bruises at the surgical site can be bothersome. In this case, drugs from the group of anticoagulants for topical use can be prescribed. If the patient has very delicate and sensitive skin, traces of bruises may persist for 1-1. 5 months.
• The development of edema may indicate that the patient does not follow the doctor's instructions, does not observe the rest regime and exposes the body, including the lower extremities, to excessive physical exertion.

Strictly follow the recommendations of the doctor, it depends on how quickly the consequences of the operation will pass.

Therefore, before deciding whether it is worth doing surgery for varicose veins, you should take into account all possible risk factors: carefully weigh the pros and cons. The operation should be performed in cases where the manifestations of the disease bother patients for a long time and significantly worsen the quality of life.

It is also necessary to consult only experienced and qualified doctors who perform such operations: phlebologists, angiosurgeons.

Recovery period

After the operation, the patient is recommended to follow all the instructions of the attending physician so that the recovery period takes as little time as possible and you can quickly return to your usual way of life. During the first 48 hours, patients are strictly prohibited from:

• The use of alcoholic beverages.
• Management of motorized transport.
• Bathing in a hot tub.
• Excessive physical activity.

In the first days after the operation, there may be complaints of pain in the legs, as well as an increase in body temperature. In this case, medical methods of therapy are involved, physiotherapy is prescribed. The patient does not always have to be in a horizontal position. You should walk a little every day to restore blood circulation.

In the future, the implementation of the following recommendations also minimizes the risk of developing these postoperative complications.

1. Hydroprocedures, massages, therapeutic exercises and other methods of physiotherapy, which will be prescribed by the attending physician. Such procedures prevent the formation of blood clots, normalize the outflow of blood.
2. During the first months, both limbs will need to be rewound with special elastic underwear or compression stockings.
3. Use drugs from the group of phlebotonics, angioprotectors. With the development of inflammatory processes, antibacterial drugs can be prescribed. Analgesics are used to relieve pain.
4. In case sutures have been applied, they can be removed 7 days after the procedure.
5. If the patient is overweight, he should be brought back to normal in order to reduce the load on the veins.
6. It is recommended to give preference to loose clothes made of natural fabrics and comfortable shoes. Wearing high heels is contraindicated.
7. At home, you should try to keep your legs elevated using rollers or pillows.

The rehabilitation period can take up to several weeks, during which time the patient will be granted special sick leave.

Modern methods of removing varicose veins involve a rehabilitation period of only a few days, but they are more expensive than usual.

In the future, the patient will have to come for a second examination and undergo an additional examination so that the doctor assesses the effectiveness of the treatment.

Operation cost

Phlebectomy is performed both in public clinics and in plastic surgery centers, the purpose of which is to eliminate aesthetic imperfections.

Patients are interested in the cost of varicose vein surgery.

It all depends on the clinic and the qualifications of the doctor who performs the procedure, as well as the degree of development of the disease and the complexity of the proposed operation. The city and region in which the patient intends to perform the procedure is not the last place in price formation.

A number of clinics include a preoperative examination, as well as a rehabilitation period, due to the cost.

Expert forecasts

The implementation of the combined phlebectomy procedure does not exclude the possibility of a recurrence of the disease. After the use of radical methods of treatment, a recurrence of varicose veins is possible due to the physiological characteristics of the body (the structure of blood vessels and veins), or a violation of the technique of performing the procedure (ifthe doctor could not normalize the patency of the affected vein). The risk of re-exacerbation of the disease is observed in about 15-20% of cases. In the event that the patient notices manifestations of a repeated relapse of the disease, it is worth consulting a doctor as soon as possible.

Only an experienced specialist will help you correctly suggest which operation to choose to eliminate varicose veins, as well as give useful recommendations that will need to be followed during the recovery period. If you do not consult a doctor in a timely manner, the consequences can be most deplorable and irreversible.