Varicose veins or varicose veins, these terms in venous biology, refer to the pathology that accompanies the deformation, that is, the deformation of the vein. The blood vessels that carry blood to the heart expand and lengthen, their walls become thinner, and the function of venous valves is destroyed.
If the first stage of varicose veins is treated very effectively by conservative methods, only surgery, drugs and other methods can cure the disease progressing to stages 2 and 3, and can only stop the pathological process. This article will focus on the main surgical methods for the treatment of varicose veins and the characteristics of their realization.
Surgical indications
In view of the lack of need for surgical intervention in the first stage of varicose vein development, a very important factor is the indication for surgery. The decision is based on the data obtained during the detailed diagnosis of the blood vessel and is made jointly by the patient and the doctor.
The phlebologist must be informed of the risks of the proposed surgery, the duration and nuances of the rehabilitation after the surgery, and these operations must then be performed with the patient's consent.
As for the indication itself, varicose vein surgery is required in this case:
- Pathological expansion and subsequent deformation of pure saphenous veins with severity above grade 2.
- The widespread form of varicose veins. The disease not only affects the saphenous veins, but also mainly affects the deep veins, or the deformation of the blood vessels extends to a large area of the lower limbs.
- There is a serious circulatory system disease, accompanied by a serious stagnant blood process.
- Severe form of edema, high-intensity pain syndrome with obvious external (aesthetic) signs of varicose veins.
- The trophic ulcer is formed on the skin or subcutaneous hematoma due to impaired vascular integrity;
- Progression of the pathological process until venous vascular obstruction and the development of acute forms of thrombophlebitis.
- In the process of conservative treatment, that is, when drugs and other methods of treating varicose veins are powerless, there is a lack of positive motivation.
Limitations and contraindications of operation
Unfortunately, even with severe forms of varicose veins, with complications and severe clinical symptoms, patients are not always able to undergo surgery.
There are many contraindications. If the possibility of surgical intervention cannot be completely ruled out, you will be forced to postpone the operation for a certain period of time:
- Ischemic heart disease-in this case, a more comprehensive comprehensive examination is necessary.
- The same applies to 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 month of pregnancy-For pregnant women, it is best to postpone any surgical operation until the woman gives birth. The only exceptions are those that pose a serious risk to the life of the mother or child, and surgery can help.
- Prevent and treat skin diseases in the area of varicose vein surgery. We are talking about eczema, various forms of skin diseases and so on.
- Of course, the elderly also have certain age restrictions. In some cases, old age and subsequent senile diseases can increase the risk of postoperative complications or endanger the lives of people on the operating table.
Surgical methods of varicose veins
However, if the doctor determines the need for surgery based on the diagnosis and after examining the patient, it is still necessary to choose the most appropriate and effective method based on the progression of varicose veins and many other factors. In order to understand what surgery is and under what circumstances, we will consider the most effective method for surgical treatment of varicose veins.
Combined Vein Resection
The complete operation performed under general anesthesia can last up to 2 hours, depending on the complexity of the task. Vein enucleation can be used to treat the initial form of varicose veins, but this method is more commonly used in advanced cases with severe disease progression.
During the operation, the surgeon will make a 2 cm incision in the ankle and a 5 cm incision in a wider area such as the groin. Usually, these incisions are shallow because the superficial veins are mainly removed.
The principle of the operation is to ligate the blood vessel anastomosis, and then remove part of the vein affected by the varicose veins. Similarly, during the operation, the surgeon can correct the venous valve to restore normal blood flow.
At the end of the operation, apply cosmetic sutures to the incision, apply dressings, and use elastic bandages on the surgical area to prevent bleeding.
Cerebellectomy
In this process, the veins in the affected area are also removed, but the scale of the operation is small and it can be regarded as pure beauty. Most importantly, the doctor made a small puncture in the skin, through which he pulled out a part of the vein that needed to be removed. This operation is mainly performed on small blood vessels, and its advantages are painless (due to local anesthesia) and the shortest recovery period.
Sclerotherapy
A relatively young technique, a minimally invasive method, known for its effectiveness, and without pain due to the same local anesthesia and almost no recovery period.
This procedure involves introducing a special substance (a foaming hardener) into the intravenous cavity. This substance can cause the walls of the container to collapse and subsequently glue. As a result, the vein stops participating in the blood circulation process, gradually dissolves and is replaced by connective tissue.
Sclerotherapy is mainly used to eliminate small superficial blood vessels and get rid of the so-called "spider veins".
Laser coagulation
According to many experts, this is the most modern and effective method of dealing with varicose veins. The essence is that the laser catheter is inserted into the venous cavity only through a 2 mm opening. When the latter is activated, it starts to emit laser waves, the temperature inside the blood vessels rises, and when the laser is removed, the vein walls collapse and stick together. Subsequently, the blood vessels disappear on their own and are replaced by connective tissue.
Of course, the main advantage of this procedure is that there are almost no visible lesions on the skin, and no rehabilitation period is required.
Possible consequences
Even the gentlest operation will leave traces and may lead to consequences. First, this is due to the fact that the anatomical part of the body has been removed-a mature blood vessel. Of course, for combined vein enucleation, this consequence may be much more serious than several contusions after laser coagulation.
Let us consider the most basic consequences that occur regularly after a certain type of surgical treatment:
- When minimally invasive methods are used to eliminate varicose veins (excluding removal of blood vessels), there is a risk of recurrence. Only during laser coagulation, this risk is very small, only 5%.
- Burns-occur after surgery using thermal effects.
- Bleeding-can start after any type of intervention, but it is more likely to start after vein removal.
- There are also cases of nerve damage, but this factor only refers to the professional level of the surgeon.
Repair process
Rehabilitation is required in each of the above cases, that is, recovery after surgery, but if the procedure only takes a few days after clotting, it may take several weeks after combined vein removal. In order for the recovery to proceed smoothly and quickly, it is important to follow simple suggestions:
- Follow the doctor’s advice carefully.
- Wear compression clothes or elastic bandages.
- If an incision occurs, it is important to wait until the wound heals.
- After the incision is healed, it is important to resume physical activity. Exercise therapy and regular walking will help.
- If your doctor prescribes any medicine, follow the instructions below.
- You can also consult a masseur after surgery and when preventing varicose veins.
- Avoid strenuous exercise for at least 2-3 months.
If the operation goes well and the patient recovers following the doctor's instructions, the chance of getting a good result is very high. In most cases, varicose veins can be cured, but this does not mean that the disease will not affect other blood vessels. Therefore, if this condition has already occurred, the prevention of varicose veins must always be carried out.