Varicose veins or varicose veins, these formulations in phlebology mean pathology accompanied by modification, that is, deformation of the veins.The vessels that transport blood to the heart dilate, lengthen, their walls become thinner and the functioning of the venous valves is disturbed.
If the first stage of varicose veins is treated very effectively with conservative methods, progression of the disease to stages 2 and 3 can only be cured surgically;Medicines and other methods can only prevent the progression of the pathology.This article will discuss the main surgical methods for treating varicose veins, the features of their implementation, and so on.
Indications for surgery
Due to the fact that in the first phase of development of varicose veins, surgical intervention is performed very rarely due to lack of need, surgical indications 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 surgery, which is subsequently carried out only with the patient's consent.
As for the indications themselves, varicose vein surgery is necessary in the following cases:
- Pathological expansion and subsequent deformation of pure saphenous veins of the second degree of severity and higher.
- Extensive forms of varicose veins, the disease affects not only the subcutaneous tissue, but mainly the deep veins, or the deformation of the vessels spreads over a very large area of the lower extremities.
- There is a serious circulatory disorder, accompanied by worsening blood stagnation.
- Severe forms of swelling, high-intensity pain, accompanied by distinct external (aesthetic) 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 up to blockage of venous vessels and 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 for surgery
Unfortunately, even if severe forms of varicose veins appear, accompanied by complications and a serious clinical condition, the patient cannot always undergo surgery.
There are a number of contraindications that, even if they do not completely exclude the possibility of surgical intervention, still force you to postpone the operation for a certain period of time:
- Coronary heart disease - in this case, it is necessary to carry out a more complete and comprehensive examination.
- The same applies to grade 3 hypertension.
- Active infectious and inflammatory processes in the body - before carrying out surgery to treat varicose veins, it is necessary to deal with the infection or eliminate inflammation.
- 2nd and 3rd trimesters of pregnancy - for pregnant women it is better to postpone any surgical procedure until delivery.The only exceptions are cases where there is a serious danger to the life of the mother or child and surgery can help.
- Skin disease in the surgical area to combat varicose veins.We are talking about eczema, various forms of dermatosis and so on.
- There are also certain age restrictions, obviously with regard to the elderly.In some cases, advanced age, as well as concomitant diseases of senility, increase the risk of developing postoperative complications or put a person's life on the operating table at risk.
Surgical intervention methods for varicose veins
If, however, the doctor, based on the diagnosis and after examining the patient, is sure of the need for surgical intervention, all that remains is to choose the most appropriate and effective method, depending on the degree of progression of varicose veins and a number of other factors.To understand what operations exist and in what cases they are performed, we will consider the most effective methods of surgical treatment of varicose veins.
Combined phlebectomy
A complete operation, carried out under general anesthesia and which can last up to 2 hours, depending on the complexity of the task.Phlebectomy can be used to treat early forms of varicose veins, but more often this method is used in advanced cases when the disease has progressed severely.
During the operation, the surgeon makes an incision of up to 2 centimeters if the operation is carried out in the ankle area or up to 5 centimeters when operating on a larger area, for example in the groin.Often these incisions are superficial, as mainly superficial veins are removed.
The principle of operation is to ligate the vessel anastomosis and then remove the part of the vein affected by varicose veins.Additionally, during surgery, the surgeon may 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 applied 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 be considered purely cosmetic.The idea is for the doctor to make 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 (due to local anesthesia) and a minimum recovery period.
Sclerotherapy
A relatively new technique, a minimally invasive method, which stands out 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 - a foamy sclerosant.This substance causes the walls of the vessel to collapse and subsequently glue them together.As a result, the vein ceases to participate in the blood circulation process, gradually disappears and is replaced by connective tissue.
The sclerotherapy technique is mainly used to eliminate small superficial vessels, as well as to eliminate so-called “vasculature veins”.
Laser coagulation
The most modern and, according to many experts, 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 measuring just 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 by itself 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 some traces and can lead to consequences.First of all, this is due to the fact that the anatomical component of the body is removed - a complete vessel.Of course, with combined phlebectomy, such consequences can be much more serious than some bruises after laser coagulation.
Let's consider the most basic consequences that periodically arise after one or another type of surgical treatment:
- When eliminating varicose veins using minimally invasive methods that exclude the removal of vessels, there is a risk of recurrence.This risk is minimal during laser coagulation, just 5%.
- Burns – occur after operations during which thermal effects were used.
- Bleeding – can start after any type of intervention, but is more likely after phlebectomy.
- Cases of nerve injuries are also known, but this factor is only related to the surgeon's level of professionalism.
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 phlebectomy it can last several weeks.To ensure that recovery occurs smoothly and quickly, it is important to follow simple recommendations:
- Strictly follow all your doctor's advice.
- Wear compression clothing or elastic bandages.
- If there were incisions, it is important to wait for them to heal.
- After the incisions have healed, it is important to restore physical activity;Exercise therapy and regular walks will help with this.
- If your doctor prescribes any medication, take it as directed.
- It is also helpful to visit a massage therapist after surgery and to prevent varicose veins.
- 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 complied with 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, varicose vein prevention should always be carried out if there have been cases of this pathology developing.