Surgery for varicose veins: indications, surgical and minimally invasive methods, course, rehabilitation. Leg vein surgery
To date, surgery for varicose veins is an ordinary procedure, it passes without complications and has only positive consequences for the body. Every year, as phlebologists note, more and more young people turn to specialists for help. The diagnosis of varicose veins is not a sentence at all! But do not forget that such a massive spread of the disease is due to the wrong way of life of people who, in a hurry for a successful career and material well-being, completely forget about their health, exposing themselves to constant stress and stress.
Varicose veins can deliver not only physical, but also moral discomfort to the patient, reducing the quality of his life. That is why you should take care of your health, seek help at the first sign of vein pathology, especially for people with a hereditary predisposition to illness and obesity, they are at risk of developing serious vascular damage. And also listen to the doctor, if you need to do an operation for varicose veins, then there is no point in delaying the solution of the problem.
Despite many innovative methods in the world of medicine, varicose veins are considered to be an incurable disease. Unfortunately, patients do not pay attention to the characteristic symptoms of the disease, attributing them to fatigue. Thus, they contribute to the development of chronic varicose veins, which can no longer be completely eliminated.
Varicose veins have several degrees, the first two are amenable to conservative treatment, but stages 3 and 4 are not complete without surgical intervention. Whether surgery is needed for stage 2 varicose veins or can the disease be treated with medicines, the doctor decides based on the tests that will be performed. As a diagnosis of varicose veins, ultrasound examination of veins with a contrast agent, a blood test, computed tomography and magnetic resonance imaging are used. As an addition, x-rays of the vessels can be performed.
Laser therapy does not leave scars or scars on the surface of the skin
Indications for surgery
The expediency of an operation to remove varicose veins is determined by the doctor on an individual basis, depending on the stage of the pathology, the age of the patient, his weight, the presence of concomitant diseases and other characteristics of the body. Surgical treatment of varicose veins is carried out with the following symptoms:
- extensive lesions of the veins;
- severe swelling of the legs;
- abnormal expansion of the veins under the skin;
- fatigue of the legs, a person cannot stand for a long time;
- trophic ulcers;
- mechanical damage to the leg;
- violations of the outflow of blood in the lower extremities;
- acute thrombophlebitis.
In addition to the above indications for surgery for varicose veins, there are also contraindications. They can reduce the effectiveness of treatment to zero and even cause additional harm to the patient's body. The operation for varicose veins of the lower extremities is not prescribed for diagnoses:
- stage 3 hypertension;
- coronary artery disease;
- inflammatory and purulent processes in the body;
- elderly age;
- period of pregnancy;
- chronic skin diseases at the stage of exacerbation;
- cancer and chemotherapy.
Before starting a surgical intervention, it is necessary to conduct a complete examination of the patient; if there are contraindications, the doctor individually develops a more gentle treatment regimen. It is important to follow the diet recommended by your doctor.
Surgery for varicose veins
There are several ways to perform surgery for varicose veins on the legs, the following methods are most often used:
- phlebectomy;
- laser correction;
- sclerotherapy.
Each operation to remove varicose veins has its own characteristics and methodology. For example, phlebectomy is done at an early stage of varicose veins on the legs, sometimes it gives good results even at grade 2 of the disease. Preparation for this type of intervention is minimal, it is enough for the patient to wash the skin of the extremities with soap and shave off the hair in the groin and on the legs.
The operation for this type of varicose veins consists in the removal of a subcutaneous vessel in which a genetic disorder occurs. The whole process takes from 1 to 2 hours, depending on the complexity of the case. In the process of surgical intervention aimed at varicose veins in the legs, the patient is made an incision in the groin area and at the ankle. The length of the incisions is no more than 5 cm, as a rule, they are shallow, so the scars will be invisible. A special instrument is inserted into them, which is commonly called a venous extractor. With it, the doctor will remove the diseased vein. After removing the vessel, the incisions are sutured, disinfected and wait until the effect of anesthesia ends. In the process of manipulation, extravasal valve correction can be carried out to normalize the outflow of blood.
After the operation is completed, the patient is covered with a sterile bandage on the leg and given recommendations for further activity. After 72 hours, a person can move independently. The postoperative period lasts 2 months. During this time, the patient must adjust his diet, wear compression stockings and use venotonics, which normalize blood circulation in the limbs.
Surgery is developing rapidly today, therefore, for some patients, to a greater extent this applies to people with second-degree varicose veins, an alternative method of surgical intervention is recommended, which does not completely remove the vein, but only eliminates only the problematic part. With varicose veins of the lower extremities of the 2nd stage, miniphlebectomy can be done under local anesthesia. As a rule, in the absence of concomitant diseases, the patient can be allowed to go home after a couple of hours and carry out further treatment on an outpatient basis.
With varicose veins, the operation can occur in different ways, one of the new methods is the treatment of varicose veins with injections. The procedure of sclerotherapy consists in the introduction of a special sclerosing substance directly into the diseased vein. Under the influence of the active components of the drug, the middle layers of the vessel stick together, and the blood circulates through healthy veins. The postoperative period is longer after this therapy, but the method gives excellent results, especially if the vein lesion is not large.
Intravascular laser coagulation, or as it is commonly called - laser treatment, is the simplest and most modern method. Such an operation for varicose veins of the lower extremities consists in the action of a laser on the walls of a diseased vessel, they are soldered when heated, and the blood changes its course. Negative consequences after the procedure are excluded, since only a small puncture is made through which the laser works. Infection and injury to other vessels is impossible. After surgery, there are no scars and the postoperative period is completely absent. After an hour, the person can walk normally.
Sometimes, doctors can use radiofrequency surgery to eliminate varicose veins, which is often practiced by American doctors. The essence of the operation is the same as with laser coagulation, only the vein is exposed to radio waves of a certain frequency. The advantage of the method is that it does not leave scars and does not require anesthesia, as it is painless. It can be used if damaged veins are too close to the skin. In rare cases, exposure to a laser can damage healthy tissues in the process of vascular adhesion, and radio waves are quite safe.
Complications and consequences of surgical treatment
No matter how talented the surgeon may be, varicose veins after surgery sometimes make themselves felt again in the form of complications. No one can guess how this or that organism will behave. After surgery to remove stage 2 and 3 varicose veins, there may be consequences that do not require treatment - bruises and hematomas, this is a normal reaction of the body to tissue damage. If the patient follows the recommendations, then everything will pass very quickly. Other consequences include:
- heavy bleeding;
- decreased sensitivity of the limb (manifested when the saphenous nerves are damaged);
- suppuration during infection;
- limb numbness, etc.
As for pain, they can only be observed during phlebectomy, the other two methods of treatment are practically painless. If subsequently there are unpleasant sensations, then they are easily stopped by analgesics.
The consequences can be serious, among the most dangerous are thromboembolism. This is an acute blockage of a blood vessel by a thrombus that has broken away from its location and circulates along with the blood stream. If the patient is not given timely assistance, then he may become disabled and even die.
Rehabilitation after surgery
The process of your recovery directly depends on how correctly you behave after surgery. There are a number of tips that will help you get on your feet as quickly as possible and at the same time not face the complications of the disease. From the first hours after the operation, you need to move your lower limbs, you do not need to get up, you can bend them or turn them to avoid congestion. It is better to lie down with your legs slightly raised, this will improve blood flow. Two days after the operation, it is recommended to start gymnastic procedures. The degree of load is decided by the attending physician. In order to prevent the formation of blood clots, a therapeutic massage and a contrast shower are prescribed.
Over the next two months, a person must follow a diet, avoiding dishes that clog blood vessels and disrupt normal blood circulation. The diet includes vitamin-containing foods that thin the blood and promote normal blood circulation. These are carrots, beets, celery and citrus fruits. Enrich your diet with whole grain cereals, they contain B vitamins, which are able to restore the energy costs of the body that has undergone surgery. In the hospital, they try to provide the patient with peace so that he recovers faster, you must do the same for your body and at home, reducing the load not only on the lower limbs, but also on the stomach, intestines and liver.
Be sure to walk outdoors in comfortable shoes. Women need to stop wearing high heels, shoes should be light and not restrict movement. After a hard day, let's rest our feet by taking contrast baths.
If necessary, the doctor will prescribe medications that must be taken in accordance with the instructions. For a while, it is worth refusing to visit saunas and baths, high temperatures can negatively affect the condition of your veins. Physical activity should be reduced, but at the same time, do not sit for a long time in one position. It is a sedentary lifestyle that is the main provocateur of varicose veins.
Whether it is worth having an operation, each person decides for himself, but it must be noted that only surgical treatment guarantees a complete recovery. The alternative method of treatment can be effective only at the initial stage of the disease, and people, as a rule, miss it, turning when the disease has passed into an acute course. The same applies to homeopathic techniques and hirudotherapy.
The process of treating varicose veins is very long and exhausting, it must be carried out strictly under the supervision of a doctor. There are a number of cases when, even after surgery, the disease returns again. In order not to face such a situation, it is better to prevent the development of the disease by visiting a doctor for preventive purposes once a year, and if you have even minor symptoms, seek help.
There are various ways to remove veins:
- phlebectomy (surgery to remove veins);
- miniphlebectomy (microphlebectomy), destruction and removal of damaged veins through small openings;
- endovenous laser coagulation (modern method of laser removal of varicose veins);
- compression sclerotherapy.
All of them are suitable for getting rid of a serious illness, however, the proven and best way out in such a situation is leg vein surgery.
Many are afraid of this operation, but they understand the need for such a responsible step. Removal of veins on the legs conducted by an experienced angiologist. Before the operation, he marks the protruding sections of the veins on the patient's leg with a special pencil. The marking is done in a standing position, since in this case the sections of the veins will be easier to recognize. After the marking procedure, the patient is placed on the operating table.
By prior arrangement, local or general anesthesia is administered. Under general anesthesia, the patient does not feel anything, and after the operation to remove the veins, he can immediately go to his home. However, the abuse of general anesthesia is contraindicated for all people, and for some it is generally prohibited.
Surgery to remove varicose veins begins with an incision in the groin (about five centimeters long) along the line where the bottom edge of the trunks passes. Then an incision is made near the ankle, on the inside of the leg (the length of the incision is about two centimeters). All other incisions are made over varicose veins. The incisions should be shallow, just enough to reach the saphenous vein.
Previously, all varicose nodes were removed. Today, it is enough to remove the largest ones, and the rest will disappear by themselves. The surgeon inserts a venous extractor through an incision in the groin, which looks like a thin wire with a round head at the end.
The extractor reaches the ankle, after which air begins to flow into it. The head of the extractor is inflated, and the doctor brings it back along with the affected vein. The communicative veins are pulled over, the incisions are sutured, and the surgical removal of the veins can be considered complete.
The operated leg is covered with sterile gauze and tightened with an elastic bandage on top. After this procedure, the patient needs to lie down.
Laser vein removal - intravascular laser coagulation, an alternative method of surgical operation.
The inner surface of the varicose vein is treated through an inconspicuous puncture with a laser beam. The blood, receiving the energy of laser radiation, immediately boils. High temperature instantly welds the wall of the problematic vessel throughout the entire thickness. The laser allows healing of venous ulcers. leg vein surgery laser treatment requires complex equipment, qualified personnel, which leads to an increased cost of laser treatment for the removal of veins.
Consequences of removing veins on the legs can develop according to two scenarios: unsuccessful and successful.
Unsuccessful consequences will provide you with bruises and hematomas, and in case of successful completion of the operation, the doctor will prescribe individual recommendations for you.
You should raise your legs and turn your torso, this will provide better blood flow. The next day, you need to be ready to bandage it with a bandage or put on compression stockings. After that, you are allowed to walk and exercise. After nine days, the patient is released from the stitches and personal rehabilitation courses are prescribed after the removal of the veins.
Rehabilitation includes:
- complete rest;
- walks in the open air;
- physical education;
- dietary compliance.
Cost of leg vein surgery. The cost of treating varicose veins varies significantly, depending on the quality and quantity of services provided. The price for the operation is estimated in tens of thousands of rubles: from 11 000 rub. up to 70-80 000 rubles. True, the total cost includes the price for laser light guides and other auxiliary products.
Today, new diseases appear every day, but no less actively progressing and long known to mankind. One of those is varicose veins. Such a disease can affect not only the veins on the legs, but also any place in the body. For example, a person may have varicose veins in the pelvis, esophagus, or uterus. The reasons for varicose veins are "sea". This includes excessive regular load on the legs, wrong lifestyle, hormonal problems, and so on. Sometimes the situation is so serious that the patient needs surgery on
Expansion of the veins in the legs
Even in well-developed countries of the world, doctors are not able to prevent the massive defeat of varicose veins. At first, the disease is not taken seriously. It is considered simply a problem that worsens the appearance of the legs. However, as the disease progresses, other more severe symptoms appear. There is swelling of the lower extremities, severe pain, the skin in the area of dilated vessels darkens, trophic ulcers may even appear, then the operation - removal of veins in the legs - is extremely necessary.
Although the root cause of the formation is a genetic predisposition, more serious stages of the disease occur when the legs are overloaded. In order for the disease to begin to progress, the body most often needs stress. It can be pregnancy, childbirth or just a sharp increase in physical activity. As a result, the pressure in the bloodstream of a person's legs rises and the normal operation of the valves is disturbed. This is the impetus for the progression of varicose veins.
secondary stage
Most often it occurs on the basis of already transferred vein thrombosis, as well as due to inherited diseases. Secondary expansion, or post-thrombophlebitic disease, is a serious problem, and if it is not given importance, then a deep pathological process begins in the circulatory system of the lower extremities.
This leads to the expansion of the saphenous veins and blockage of large vessels, as the valves do not have time to cope with the increasing pressure. Also, re-expansion of the veins can occur due to arteriovenous fistulas. In rare severe forms, the Klippel-Trenaunay syndrome develops, which also leads to the secondary stage of the disease.
Surgical operations on the veins of the lower extremities
When a person comes to despair in the fight against varicose veins, one has to resort to a surgical solution to the problem, namely, the removal of the enlarged section of the venous vessels. If the operation is performed by experienced and conscientious surgeons, it can save a person from the disease and from the discomfort associated with it for many years.
Modern medicine has all the necessary developments and tools for a successful leg vein operation. An interesting new method of seamless technology. The affected areas of the circulatory system are removed using micropunctures.
After such an operation, suturing is not even required. The patient's leg is simply wrapped with an elastic bandage, and after only five hours he can already get up and walk a little. No matter how difficult the operation on the veins of the legs is, the consequences may still make themselves felt for some time. For example, the compression period after any surgical procedure can be from one to three months.
If a person has had trophic ulcers on his legs, then surgeons use endoscopic equipment. Gradually, the most painful and terrible methods of removing dilated blood vessels are being replaced by more civilized ones.
Operating methods
The most common treatment for varicose veins in the legs is phlebectomy.
Medications, including anesthesia, are administered through the epidural opening in the spine (using a catheter). This method contributes to high-quality pain relief, while maintaining consciousness, reducing harm and stress for the body.
Although at the moment many methods have been invented for the operation, the method is used more effectively. It consists of several stages.
The first step is called a crossectomy. It consists in the intersection of the great saphenous vein at the place of its confluence with the femoral. It is convenient to carry out such work from an incision in the inguinal part, this also allows you to freely bandage the tributaries that are close to the anastomosis.
The next part of the operation is the actual removal of a fragment of the great saphenous vein. In some cases, the required varicose vein surgery involves a small area of blood vessels in the femoral region only. And sometimes they use long stripping (this is the name of the removal of the vein itself), that is, the subcutaneous vein is completely removed - from the groin to the ankle.
In this case, the vessels are pulled out using a special probe. To understand how this withdrawal occurs, imagine how the stocking is turned inside out when removed from the leg. Approximately so the vein is taken out at full removal. This method allows you to preserve the integrity of the remaining elements of the circulatory system, do not damage the surrounding tissues, and avoid the appearance of scars and hematomas. If this is how the operation on the veins of the legs was performed, the rehabilitation will be faster and easier.
After the main trunk has been removed, they begin to eliminate the tributaries damaged by varicose veins. Moreover, if which connect the deep veins with the superficial ones, they are also susceptible to pathology, they must be bandaged. Dressings are performed from separate small incisions.
Preparing for the operation
In order for the operation on the vein on the leg to be successful, you need to properly prepare for it. The attending physician gives the necessary directions, among which there will necessarily be blood tests, urine tests, a cardiogram, and fluorography. Women will need to go through a gynecologist, and some patients still need to get permission to admit the operation from the therapist. You should also purchase a few elastic bandages at the pharmacy in advance and take them with you when you check into the hospital.
Phlebectomy is indicated for patients diagnosed with varicose veins associated with problems in the saphenous veins (large or small).
To whom phlebectomy is contraindicated
In no case should this method be used by pregnant and breastfeeding women. It is also worth considering the general condition of the patient and other pathologies to which he may be susceptible. Do not do phlebectomy for those who have exacerbated thrombosis or thrombophlebitis of the veins, as well as in the presence of purulent formations on the legs.
Foam sclerotherapy of veins
Sclerotherapy is a relatively new and successful method of treating varicose veins without traumatic intervention. Such operations are performed on the veins of the legs with a laser. Such sclerotherapy is especially effective in removing small dilated veins. And in the treatment of vascular networks, asterisks, this technique is simply irreplaceable.
Operations on the veins of the legs with a laser
With such an intervention, only the energy of the laser beam acts on the problem area, as a result of which the vein is thermally closed. The procedure has a relatively high cost, and it requires specially trained medical personnel.
Thanks to this method, it became possible to deal with the causes of the appearance of trophic ulcers. Such an operation - removal of veins in the legs - has become the most modern and effective, so patients quickly recover without feeling any negative consequences.
What is radio frequency obliteration?
This is no less safe and modern operation on the veins of the legs. Reviews about this technique are quite good. It is painless and easy to understand for the patient. However, after the surgical procedure, the legs may hurt for some time, and this method cannot be used to treat perforating veins.
The dangers of varicose veins
Alas, this problem is extremely common in society. On average, over 30% of the population has swollen veins. In 20% of cases, varicose veins are complicated by the appearance of trophic ulcers, and more than 25% of cases go into the stage of thrombophlebitis. This behavior of the disease can often lead to even more serious consequences.
Risks of thrombophlebitis
This complication occurs more often than others and carries with it a serious problem, as it can cause blockage of deep veins. It is caused by a slowdown in high-quality blood circulation in the vessels of the lower extremities. Leads to edema, trophic ulcers, darkening of the skin in the affected area.
What is a trophic ulcer?
Such an ulcer is a sign of a severe one. If not properly treated, it may not heal for a long time, even progress, damaging your legs more and more. After surgery on the veins, this problem is solved more easily.
Venous thrombosis and thromboembolism
Such thromboses can increase the risk of thrombophlebitis, and thromboembolism in general can lead to serious pulmonary and heart failure, which in half of the cases is fatal.
Recovery after surgery
Regardless of how the varicose vein surgery went, in order to recover, you need to follow the course prescribed by your doctor. When recommending treatment, the doctor will take into account how badly the veins were damaged, how much blood outflow is impaired.
After the operation on the vein in the leg has been carried out, the first 4 hours should be in bed. However, this does not mean that you need to lie still. The doctor will tell you how to bend your legs and what movements to make with your ankle joints to speed up recovery. Sometimes it will be necessary to bandage the lower limbs with an elastic bandage or even secure them in a raised state.
The next day the doctors will allow the patient to sit up. After both legs are bandaged with an elastic bandage, the patient will try to get up and walk around the ward.
Finally, everything is over, an operation was performed on the veins of the legs. Reviews about it, of course, can be both positive and negative. Nevertheless, we must not forget that it is necessary to maintain the health of blood vessels further. In this case, a special massage will come to the rescue, as well as regular walking. All this will help to avoid varicose veins today and in the future!
Varicose veins are one of the most common diseases these days. Unfortunately, patients often go to the doctor when the disease is already too advanced and the lesions of the veins are large enough. Therefore, wearing special compression underwear or following a diet and lifestyle is no longer enough. In this case, you will need removal of the great saphenous vein and other affected vessels. Laser surgery is quite expensive and not always available, so traditional surgery remains in high demand.
Why do you need to have a vein removal surgery?
You should know that phlebectomy or surgery to remove a vein is not dangerous, although the possibility of complications is not excluded. Before prescribing an operation, the doctor must examine the patient in order to exclude contraindications and possible complications, clarify the diagnosis and assess the risks.
Why is such an operation necessary? Its goal is to eliminate the stagnation of venous blood in the vessel by removing these very vessels. Another important step: this way you can prevent the flow of blood from deep veins to superficial ones, that is, change the movement of blood flow. During the operation, the specialist removes those parts of the vein in which the valves do not work. This is necessary so that stagnant blood stops exerting pressure on the walls of the vessel, the soft tissues that surround it, fiber and skin. If such blood pressure is not eliminated, then this will lead to an expansion of the inflows of the superficial venous network.
Removal of the great saphenous vein called stripping. This is one of the most common varicose vein surgeries. This is due to the fact that, as a rule, patients seek help too late, when low-traumatic methods of vein removal are no longer effective. Usually, deep veins are not affected by varicose veins, mainly superficial vessels suffer from it, so you should not be afraid that as a result of removal, the blood will not be able to move along the lower limb - it will simply move through the deep veins.
The main stages of removal of the great saphenous vein
There are two types of stripping:
. Traditional stripping or Bebcock operation;Cryostripping.
The first type of operation is based on the removal of a vein using a special surgical probe. The patient is prepared for the operation, and it begins with the fact that two incisions are made to him: in the inguinal region and in the upper part of the lower leg. The surgeon inserts a probe into one of them, directing it into the lumen of the vessel. Then the probe is advanced to the second incision, engaging and pulling the damaged vein. Manipulation is accompanied by bleeding and tissue damage, complications are sometimes possible, but this is the only way to get rid of varicose veins in especially advanced cases when it is impossible to save a vein.
During cryostripping, the vessel is glued to a surgical probe at a temperature of -85 degrees Celsius. The vein is then pulled out and removed. This method has the following advantages: less trauma, the need for only one incision, a quick rehabilitation period.
At the end of the operation, an elastic bandage is applied to the patient and he must restore motor activity as soon as possible in order to avoid the occurrence of thrombosis and other complications. Compliance with all stages and features of the operation guarantees its success, so you should not ask the surgeon to make fewer incisions. The fact is that in this way the doctor is deprived of the opportunity to remove the entire trunk of the damaged vein, which means a high probability of relapse in a short time after the operation.
rehabilitation period
Any operation is to some extent the risk and likelihood of complications. You should not be afraid of them, you just need to be prepared for their appearance and have information on how to avoid them. The most common occurrence after surgery to remove the great saphenous vein is bruising and small lumps - these disappear within a few months.
Do not apply compresses to the operated leg or apply warming ointments. In some cases, there may be a violation of sensitivity in some parts of the leg, especially on the inner surface of the ankles - this phenomenon will also pass on its own. It is caused by the fact that during the operation the sensitivity of the nerve endings was disturbed. Sometimes the patient has postoperative swelling or pain, this may also be associated with physical activity. In this case, it is necessary to use compression underwear and eliminate the cause of edema.
If you follow all the recommendations of the doctor, then the likelihood of the return of varicose veins is low. After the operation, it is necessary to use an elastic bandage daily for several months. The doctor may prescribe additional drugs to increase the tone of the veins. The duration of the rehabilitation period depends on the severity of varicose veins. It is better to refrain from visiting a bath or sauna during the first ten days, but simple exercises in the form of flexion and extension, leg rotations are recommended to be performed already from the first hours after the operation.
In our medical center, you will be given a complete diagnosis of varicose veins using modern equipment and an effective treatment method will be selected. Follow the recommendations of a specialist - and you will get rid of this unpleasant disease. You can apply for a consultation at a time convenient for you, but it is better not to postpone a visit to the doctor so that the disease does not go into a serious stage.
