Types of operations to eliminate varicose veins and possible consequences

Varicose veins or varicose veins, these formulations in phlebology designate a pathology accompanied by a modification, that is to say a deformation of the veins.The vessels carrying blood to the heart dilate, lengthen, their walls become thinner and the functioning of the venous valves is disrupted.

If the first stage of varicose veins is treated very effectively with conservative methods, then the progression of the disease to stages 2 and 3 can only be cured surgically;medications and other methods can only stop the progression of the pathology.This article will discuss the main surgical methods of treating varicose veins, features of their implementation, etc.

Surgical indications

Since at the first stage of the development of varicose veins, surgical intervention is extremely rare due to the lack of necessity, indications for surgery are a very important factor.The decision is based on data obtained during a detailed vascular diagnosis and is made by the patient together with the doctor.

The phlebologist is obliged to talk about the risks of the proposed operation, the duration and nuances of rehabilitation after surgical intervention, which are subsequently carried out only with the consent of the patient.

As for the indications themselves, varicose vein surgery is necessary in the following cases:

• Pathological expansion and subsequent deformation of purely saphenous veins of the second degree of severity and above.
• Extensive forms of varicose veins, the disease affects not only the subcutaneous veins, but mainly the deep veins, where the deformation of the vessels extends over too large an area of the lower limbs.
• There is a serious circulatory disorder, accompanied by worsening blood stagnation.
• Severe forms of swelling, pain of high intensity, accompanied by distinct external (aesthetic) signs of varicose veins.
• Formation of trophic ulcers on the skin or subcutaneous hematomas due to disruption of the integrity of blood vessels;
• Progression of the pathological process up to blockage of venous vessels and the development of an acute form of thrombophlebitis.
• Lack of positive dynamics during conservative treatment, that is, when medications and other methods of combating varicose veins are powerless.

Restrictions and contraindications to surgery

Unfortunately, even if severe forms of varicose veins develop, accompanied by complications and a severe clinical picture, the patient cannot always undergo surgical intervention.

There are a number of contraindications which, although they do not completely exclude the possibility of surgical intervention, nevertheless require postponing the operation for a certain time:

• Coronary heart disease - in this case it is necessary to carry out a more complete comprehensive examination.
• The same goes for grade 3 hypertension.
• Active infectious and inflammatory processes in the body - before performing surgery to treat 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 intervention until delivery.The only exceptions are cases where there is serious danger to the life of the mother or child and surgery can help.
• Skin disease in the field of surgery to combat varicose veins.We are talking about eczema, various forms of dermatoses, etc.
• There are also some age restrictions, especially for older people.In some cases, advanced age, as well as accompanying diseases of senility, increase the risk of developing postoperative complications or endanger the life of a person on the operating table.

Methods of surgical intervention for varicose veins

If, however, 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 varicose veins and a number of other factors.To understand what operations are there and in what cases they are performed, we will consider the most effective methods of surgical treatment of varicose veins.

Combined phlebectomy

A full-fledged operation, which takes place 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 most often used in advanced cases when the disease has seriously progressed.

During the operation, the surgeon makes an incision up to 2 centimeters long if the operation is carried out at the ankle or up to 5 centimeters when operating on a larger area, for example at the groin.These incisions are often shallow, as it is mainly the superficial veins that are removed.

The principle of the operation is to ligate the anastomosis of the vessel then to remove the part of the vein affected by the varicose veins.Additionally, during surgery, the surgeon can correct the venous valves to restore normal blood flow.

At the end of the operation, cosmetic stitches are placed on the incisions, a bandage is made and an elastic bandage is applied to the operated area to prevent bleeding.

Miniphlebectomy

During this procedure, the affected area of the vein is also excised, however, the scale of the operation is smaller and can rather be considered purely cosmetic.The idea is that the doctor makes a small puncture in the skin, through which he removes the part of the vein that needs to be cut.This operation is performed mainly on small vessels and has the advantages of being painless (thanks to local anesthesia) and a minimal recovery period.

Sclerotherapy

A relatively new technique, a minimally invasive method, famous for its effectiveness, as well as the absence of pain due to the same local anesthesia and a practically non-existent rehabilitation period.

The procedure involves the introduction of a special substance into the lumen of the vein - foaming sclerosant.This substance causes the walls of the container to collapse during their subsequent gluing.As a result, the vein ceases to participate in the blood circulation process, gradually reabsorbs and is replaced by connective tissue.

The sclerotherapy technique is mainly used to eliminate small superficial vessels, as well as to get rid of “spider veins”.

Laser coagulation

The most modern and, according to many experts, the most effective way to combat varicose veins.Its essence lies in the fact that a laser light guide is inserted into the venous lumen through a hole of only 2 millimeters.When the latter is activated, it begins to emit laser waves, the temperature inside the vessel increases, and as the laser is removed, the walls of the vein collapse and stick together.Subsequently, the vessel disappears on its own and is replaced by connective tissue.

Of course, the main advantage of this procedure is the almost complete absence of visible damage to the skin, as well as the absence of the need for a rehabilitation period.

Possible consequences

Even the most gentle operation leaves certain traces and can have consequences.First of all, this is due to the fact that the anatomical component of the body is removed - a full-fledged vessel.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:

1. When eliminating varicose veins using minimally invasive methods excluding vessel removal, there is a risk of relapse.This risk is minimal during laser coagulation, only 5%.
2. Burns – occur after operations in which thermal effects were used.
3. Bleeding – can start after any type of procedure, but is more likely after a phlebectomy.
4. There are also known cases of nerve damage, but this factor only concerns 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 clotting this process takes only a few days, after combined phlebectomy it can last several weeks.To ensure a smooth and quick recovery, it is important to follow simple recommendations:

1. Strictly follow all advice from your doctor.
2. Wear compression garments or elastic bandages.
3. If there have been incisions, it is important to wait for them to heal.
4. Once the incisions have healed, it is important to resume physical activity;Exercise therapy and regular walks will help with this.
5. If your doctor prescribes medications, take them as directed.
6. It is also helpful to consult a massage therapist after surgery and prevent varicose veins.
7. For at least 2 to 3 months, you should not expose yourself to intense physical activity.

If the operation went well and the patient fully followed all the doctor's instructions regarding recovery, the probability 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 vessels.For this reason, the prevention of varicose veins should always be carried out if there have been cases of the development of this pathology.