Varicose veins or varicose veins, this formulation in phlebology means pathology accompanied by modification, that is, deformation of veins.The vessels that transport blood to the heart are folded, lengthened, their walls become thinner, and the function of the venous valves is disturbed.
If the first stage of varicose veins is very effectively treated with conservative methods, then the progression of the disease to stages 2 and 3 can only be cured surgically;Medicines and other methods can only stop the development of pathology.This article will discuss the main surgical methods to treat varicose veins, the characteristics of their implementation, and so on.
Indications for surgery
Due to the fact that in the first stage of the development of varicose veins, surgical intervention is performed very rarely due to the lack of need, the indication for surgery is a very important factor.The decision is based on data obtained during a detailed vascular diagnosis and 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 recovery after the operation, which is then carried out only with the patient's consent.
As for the signs themselves, surgery for varicose veins is required in the following cases:
- Pathological development and subsequent deformation of the saphenous vein is only the second and higher degree of severity.
- Vast forms of varicose veins, this disease does not only affect the subcutaneous, but especially the deep veins, or deformation of the vessels that spread over an area that is too large in the lower part of the leg.
- There is a serious circulatory disorder, accompanied by worsening blood loss.
- A severe form of swelling, high intensity pain, accompanied by external (aesthetic) signs that are different from varicose veins.
- The formation of trophic ulcers on the skin or subcutaneous hematoma due to disruption of the integrity of blood vessels;
- The progression of the pathological process until the blockage of venous vessels and the development of acute thrombophlebitis.
- Lack of positive dynamics during conservative treatment, that is, when drugs and other methods to combat varicose veins are powerless.
Restrictions and contraindications for surgery
Unfortunately, even if severe forms of varicose veins develop, accompanied by complications and a severe clinical picture, patients cannot always undergo surgery.
There are some contraindications that, although they do not completely exclude the possibility of surgical intervention, still force a person to postpone the operation for a certain period of time:
- Coronary Heart Disease - In this case, it is necessary to perform a more complete comprehensive examination.
- The same goes for grade 3 hypertension.
- Infectious and inflammatory processes are active in the body - before performing surgery to treat varicose veins, you need to overcome the infection or eliminate the inflammation.
- 2nd and 3rd pregnancy generation - For pregnant women, it is better to postpone any surgical procedure until the woman gives birth.The only exception is cases when there is a serious danger to the life of the mother or child, and surgery can help.
- Skin diseases in the surgical area to combat varicose veins.We are talking about eczema, various forms of dermatosis, etc.
- There are also certain age restrictions, of course regarding the elderly.In some cases, advanced age, as well as accompanying diseases, increase the risk of developing postoperative complications or endangering the life of a person on the operating table.
Methods of surgical intervention for 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 appropriate and effective method, depending on the degree of development of varicose veins and several other factors.To understand what operations are available and in which cases they are performed, we will consider the most effective surgical methods for vein surgery.
Combined phlebectomy
The full operation, which is performed under general anesthesia and can last up to 2 hours, depends 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 seriously.
During the operation, the surgeon makes an incision up to 2 centimeters long if the operation is performed in the ankle area or up to 5 centimeters when operating in a larger area, for example, in the groin.Often this incision is shallow, because mainly superficial veins are removed.
The principle of operation is to tie the anastomosis of the vessel and then remove the part of the vein affected by the varicose vein.Also, during surgery, the surgeon can fix the venous valve to restore normal blood flow.
Upon completion of the operation, cosmetic sutures are placed on the incision, 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 removed, however, the scale of the operation is smaller and better considered purely cosmetic.The idea is that the doctor makes a small puncture in the skin, where he removes the part of the vein that needs to be cut.The operation is performed mainly in small vessels, and its advantages include pain (due to local anesthesia) and a minimal recovery period.
Sclerotherapy
A relatively new technique, a minimally invasive method, which is known for its effectiveness, as well as the absence of pain due to the same local anesthesia and an impractical recovery period.
This procedure involves the introduction of a special substance into the lumen of the vein - foamy sclerosant.This material causes the walls of the ship to collapse with subsequent stickers.As a result, veins no longer participate in the blood circulation process, gradually settling and being replaced by connective tissue.
The technique of sclerotherapy is mainly used to eliminate small superficial vessels, and also to eliminate the so-called "spider veins".
Laser freezing
The most modern and, according to many experts, an effective way to combat varicose veins.The point lies in the fact that the laser light guide is inserted into the lumen of the vein through a hole of only 2 millimeters.When the latter is activated, it begins to emit laser waves, the temperature inside the vessel rises, and when the laser is removed, the walls of the veins collapse and stick together.Next, the vessel disappears on its own and is replaced by connective tissue.
Of course, the main advantage of this procedure is the absence of almost any damage to the skin, as well as the absence of the need for a recovery period.
Possible consequences
Even the most gentle operations leave certain traces and can cause consequences.First of all, this is due to the fact that an anatomical component of the body is removed - a full vessel.Of course, with combined phlebectomy, such consequences can be more serious than a few bruises after laser coagulation.
Let's consider the most basic consequences that periodically arise after one or type of surgical treatment:
- When eliminating varicose veins using a minimally invasive method that excludes the removal of vessels, there is a risk of recurrence.This risk is minimal during laser freezing, only 5%.
- Burns - occur after operations where heat effects are applied.
- Bleeding - can start after any type of intervention, but more likely after phlebectomy.
- There are also known cases of nerve damage, but this factor is only related to the level of professionalism of the surgeon.
The recovery process
Recovery, i.e. recovery after surgery, is required in each of the described cases, but if after coagulation this process takes only a few days, then after combined phlebectomy it can last for several weeks.To ensure that the recovery goes smoothly and quickly, it is important to follow these simple recommendations:
- Follow all your doctor's advice strictly.
- Wear compression garments or elastic bandages.
- If there are incisions, it is important to wait for them to heal.
- After the incision has healed, 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 useful to visit a massage therapist after surgery and to prevent varicose veins.
- For at least 2-3 months, you should not expose yourself to serious physical activity.
If the operation goes well and the patient fully complies with all the doctor's instructions regarding recovery, the probability of a good result 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, prevention of varicose veins should always be carried out if there are cases of the development of this pathology.