Varicose veins or varicose veins, these formulas in phlebology mean pathology accompanied by transformation, that is, deformation of the veins.The vessels that transport blood to the heart dilate, lengthen, their walls become thinner, and the work of venous valves is disrupted.
If the early stages of varicose veins are treated very effectively with conservative methods, the disease will progress to stages 2 and 3 which can only be cured with surgery;Medicines and other methods can only stop the progression of the pathology.This article will discuss the main surgical methods for treating varicose veins, their performance features, etc.
Indications for surgery
Since at the early stages of development of varicose veins, surgical intervention is performed extremely rarely due to unnecessary reasons, the indication for surgery is a very important factor.This decision is based on data obtained during a detailed vascular diagnosis and is made by the patient together with the doctor.
The surgeon is obliged to tell about the risks of the proposed operation, the duration and nuances of the post-operative recovery process, which is then carried out only with the patient's consent.
Regarding indications, varicose vein surgery is necessary in the following cases:
- Pathological enlargement and subsequent deformation of the pure saphenous veins of the second or higher degree of severity.
- Widespread forms of varicose veins, the disease not only affects the subcutaneous area but mainly the deep veins, or the deformation of blood vessels spreads to too large an area of the lower limbs.
- There is a serious circulatory disorder, accompanied by worsening blood stagnation.
- Severe forms of swelling, intense pain, accompanied by obvious external (cosmetic) signs of varicose veins.
- Formation of trophic ulcers on the skin or subcutaneous hematomas due to violation of the integrity of blood vessels;
- Progression of the pathological process leads to congestion of venous blood vessels and the development of an acute form of thrombophlebitis.
- Lack of active motivation during conservative treatment, that is, when drugs and other anti-varicose methods are powerless.
Limitations and contraindications of surgery
Unfortunately, even when severe forms of varicose veins develop, accompanied by complications and serious clinical picture, the patient does not always require surgery.
There are a number of contraindications that, even if they do not completely exclude the possibility of surgical intervention, still force people to postpone surgery for a certain period:
- Coronary heart disease - in this case a more comprehensive examination is required.
- The same applies to stage 3 hypertension.
- Inflammatory and infectious processes are taking place in the body - before proceeding with surgical treatment of varicose veins, you need to deal with the infection or eliminate inflammation.
- 2nd and 3rd trimesters of pregnancy - for pregnant women, it is better to postpone any surgical procedures until the woman gives birth.The only exception is cases where the life of the mother or child is seriously dangerous and surgery can help.
- Skin diseases in the surgical area to prevent varicose veins.We're talking about eczema, different forms of dermatological diseases, and more.
- Of course there are also certain age restrictions for older people.In some cases, advanced age, as well as accompanying senility, increases the risk of developing complications after surgery or endangering the life of the person on the operating table.
Surgical intervention methods to treat varicose veins
However, if the doctor, based on the diagnosis and after examining the patient, 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 the varicose veins and a number of other factors.To understand what operations there are and in what cases they are performed, we will consider the most effective surgical treatments for varicose veins.
Combined phlebectomy
A formal operation, 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 usually used in severe cases where the disease has progressed significantly.
During surgery, the surgeon will make an incision up to 2 cm long if surgery is being performed in the ankle area or up to 5 cm long when operating on a larger area, such as in the groin.Usually these incisions are shallow because mainly superficial veins are removed.
The principle of surgery is to ligate the vascular anastomosis and then remove the part of the vein affected by the varicose veins.Additionally, during surgery, the surgeon can adjust the venous valves to restore normal blood flow.
After completing the surgery, cosmetic stitches will be placed on the incision, bandaged, and an elastic bandage will be applied to the surgical area to prevent bleeding.
Removal of small veins
During this procedure, the affected vein area is also removed, however, the scale of the operation is smaller and can be considered purely cosmetic.The idea is that the doctor will make a small puncture in the skin, through which he will pull out the vein that needs to be removed.This operation is performed mainly on small vessels and its advantages include painlessness (due to local anesthesia) and minimal recovery time.
Sclerotherapy
A relatively new technique, a minimally invasive method, is renowned for its effectiveness as well as being painless due to the same local anesthesia and practically no rehabilitation period.
This procedure involves the introduction of a special substance into the lumen of the vein - a foaming sclerosant.This substance causes the walls of the jars to collapse when they are glued later.As a result, veins stop participating in blood circulation, gradually degenerate and are replaced by connective tissue.
Sclerotherapy techniques are used primarily to remove small superficial blood vessels, as well as to remove so-called “spider veins.”
Laser coagulation
According to many experts, this is the most modern and effective way to fight varicose veins.Its essence lies in the fact that a laser light guide is inserted into the vein through a hole of only 2 mm.When the latter is activated, it begins to emit laser waves, the temperature inside the vessel increases, and when the laser is removed, the walls of the vein collapse and stick together.The blood vessels then disappear and are replaced by connective tissue.
Of course, the main advantage of this procedure is that there is almost no visible damage to the skin, as well as no recovery time.
Possible consequences
Even the gentlest manipulations leave certain traces and can lead to consequences.First of all, this is due to the anatomical composition of the body - a full-fledged vessel has been removed.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 periodically arise after one or another type of surgical treatment:
- When varicose veins are removed using minimally invasive methods that exclude vessel resection, there is a risk of recurrence.This risk is minimal during laser coagulation, only 5%.
- Burns – occur after activities using thermal effects.
- Bleeding - can begin after any form of intervention, but usually occurs after phlebectomy.
- There are also known cases of nerve damage, but this factor is related only to the level of professionalism of the surgeon.
Rehabilitation process
Rehabilitation, that is, recovery after surgery, is necessary in each of the described cases, but if after coagulation this process takes only a few days, then after combined phlebotomy it can last for several weeks.To ensure a smooth and quick recovery, it is important to follow simple recommendations:
- Please strictly follow all your doctor's advice.
- Wear compression garments or elastic bandages.
- If there have been surgical incisions, it is important to wait for them to heal.
- After the incision heals, it is important to resume physical activity;Exercise therapy and regular walking will help with this.
- If your doctor prescribes any medications, take them as directed.
- It is also helpful to see a massage therapist after surgery to prevent varicose veins.
- For at least 2-3 months, you should not be exposed to severe physical activity.
If the surgery goes well and the patient fully complies with all of the doctor's instructions regarding recovery, the likelihood 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, the prevention of varicose veins must always be carried out if there have been cases of the development of this pathology.