Removal of veins in the lower extremities is called radical methods of treatment. Surgery to remove varicose veins in the legs may be prescribed to the patient if the use of conservative and alternative methods of therapy does not bring the right therapeutic effect, and the disease continues to progress.
In the advanced form of varicose veins, surgery can solve the following problems:
- Eliminate the pathological reflux (reflux) of blood.
- Save disease-free, healthy sections of the trunk veins.
- Eliminate the affected areas of the veins.
Before the operation, the doctor marks the veins under ultrasound control, which allows you to determine the extent of the affected section. The affected vessels and vein sections are removed with a narrow probe that is inserted through a small incision in the skin. After the affected area is removed, the risk of the disease recurring is low.
After surgery to remove a varicose vein, the likelihood of the disease recurring is low.
In modern medicine, they prefer the procedure of combined phlebectomy, in which several techniques are used at once.
The main stages of combined radical treatment are: upper or lower crossectomy, short stripping, perforating vein ligation, mini-phlebectomy.
At the initial stage of the disease, any of the listed procedures can be used as an independent operation. In some cases, minimally invasive treatment methods in the form of sclerotherapy or laser sclerotherapy can be offered as an alternative to some stages of classic combined phlebectomy.
types of operations
The common name for the surgery to remove the affected veins is phlebectomy. Modern types of this procedure:
- Performing the stripping procedure (long or short) is the most gentle technique, allowing the doctor to remove only a specific part of the affected vein. The procedure is performed through a small incision along the vein.
- Performing laser phlebectomy is a modern method of treatment that involves the use of a laser. Thanks to this tool, the process of laser coagulation takes place in the affected vessels. The procedure is performed under local anesthesia and does not require any special surgical instruments. The laser is injected into the vein together with a small-diameter catheter, then under the influence of the pulse small vapor bubbles are formed, affecting the walls of the vessels. As a result, the affected vein becomes part of the tissue and no longer bothers the patient.
- Endoscopic excision of the affected vein. In this case, an endoscope is inserted into the vein area, and the doctor can personally analyze the condition and degree of damage. In the future, the surgeon has the opportunity to cut off the affected area.
The so-called seamless technologies, in which the affected area of the vein is cut out with small precise incisions, are very popular. Already 4-6 hours after the manipulation, the patient can walk independently. In the event that the development of trophic disorders is observed, endoscopic equipment is used.
The advantage of the miniphlebectomy method
Miniphlebectomy is one of the most painless and atraumatic methods of surgical removal of affected veins. The procedure is carried out in three stages: diagnosis, small incision with a scalpel at the site of circulatory disorders, extraction of the affected area of \u200b\u200bthe vein.
The operation is performed under local anesthesia, the rehabilitation period does not take much time from the patient. Scars, bruises do not form at the puncture site, pain is disturbed in isolated cases.
Miniphlebectomy is an almost painless method of eliminating varicose veins, the recovery period after the operation is minimal.
To minimize the risk of bruising and bruising, the operation can be performed with tumescent anesthesia, which, in addition to the anesthetic, contains a substance that has a vasoconstrictive effect. After the procedure, the patient is discharged after a few hours, while there is no intoxication characteristic of general anesthesia, as well as pain.
crossectomy
The term "crossectomy" means ligating and then crossing a small or large saphenous vein. As a stand-alone operation, such a procedure can only be performed in emergencies when there is a risk of spreading acute thrombosis.
So far, there are gentler alternative methods to crossectomy - endovascular laser ablation and radiofrequency ablation.
The advantages of the techniques are: the ability to refuse general anesthesia, outpatient treatment, the absence of cosmetic defects in the form of scars from incisions and scars.
Among the disadvantages, one can note a higher probability of recurrence of the disease and a rather high cost of these procedures.
education
The operation for varicose veins of the lower extremities is performed after a preliminary examination of the patient and conducting an internal examination.
The following test types can be assigned:
- Ultrasound of leg veins.
- General blood analysis.
In the future, the doctor will conduct an oral survey to identify possible contraindications to surgical intervention. A preliminary examination allows you to choose the optimal type of surgical procedure or, if necessary, to combine several known methods at once.
It is very important that the patient understands how to behave properly before and after the procedure. Before the operation, it is recommended to avoid taking medications containing acetylsalicylic acid because of the risk of bleeding. On the day of the operation, it is not necessary to prepare for the procedure particularly carefully - you just need to remove the hair in the area of \u200b\u200bthe operated limb.
When is surgery required?
Patients who are wondering whether there is a need for surgery for varicose veins of the lower extremities should understand that such a radical method of therapy is necessary in the following cases:
- The rapid progression of the disease, which is accompanied by severe pain.
- The development of varicose thrombophlebitis of 1-4 degrees.
- Sensation of intense heat and burning in the area of the veins.
- The spread of varicose veins over the kneecaps.
- Visible formation of a swollen, aesthetically unsightly vein.
The operation is also indicated in the development of long-lasting, non-healing trophic disorders (ulcers) where conservative therapy does not have the right therapeutic effect.
Contraindications and possible consequences
It is imperative to consider possible contraindications and consequences of surgical intervention.
Surgical intervention can not be performed if the patient has a history of such diseases as hypertension, cardiac arrhythmia, coronary artery disease, the presence of infectious diseases in the acute stage, dermatological inflammatory diseases in the legs.
The operation should not be performed in late pregnancy, as well as in elderly patients with weakened immunity.
Patients should consider possible complications, as well as the consequences of surgical intervention:
- Violation of the sensitivity of the operated limb due to damage to the nerve endings.
- Intermittent or persistent numbness in the ankle area.
- The formation of suppuration.
- The development of bleeding of varying intensity.
- Re-education of protruding veins at a site above or below postoperative scars.
- Pain syndrome does not bother all patients and occurs when the nerve endings are affected. Normalization of sensitivity in most cases occurs independently, without the use of drugs.
- Hematomas and bruises at the surgical site can be bothersome. In this case, drugs from the group of anticoagulants can be prescribed for topical use. If the patient has very sensitive and sensitive skin, then traces of bruising can persist for 1-1. 5 months.
- The development of edema may indicate that the patient does not follow the doctor's orders, does not comply with the rest regime and exposes the body, including the lower limbs, to excessive physical exertion.
Strictly adhere to the doctor's recommendations, it depends on how quickly the consequences of the operation will pass.
Therefore, before deciding whether surgery for varicose veins is worthwhile, you should consider all possible risk factors: carefully weigh the pros and cons. The operation should be performed in cases where the manifestations of the disease bother patients for a long time and significantly worsen the quality of life.
It is also necessary to consult only experienced and qualified doctors who perform such operations: phlebologists, angiosurgeons.
recovery period
After the operation, the patient is recommended to follow all the instructions of the attending physician so that the recovery period takes as little time as possible and you can quickly return to your usual lifestyle. During the first 48 hours, patients are strictly prohibited from:
- The use of alcoholic beverages.
- motor traffic management.
- Bathing in a hot tub.
- Excessive physical activity.
In the first few days after the operation, complaints of pain in the legs and an increase in body temperature may occur. In this case, we are talking about medical methods of therapy, physiotherapy is prescribed. The patient should not always be in a horizontal position. You should take a little walk every day to restore blood circulation.
In the future, the implementation of the following recommendations will also minimize the risk of developing these postoperative complications.
- Hydroprocedures, massages, therapeutic exercises and other methods of physiotherapy prescribed by the attending physician. Such procedures prevent the formation of blood clots, normalize blood outflow.
- In the first few months, both limbs must be wrapped in special elastic underwear or compression stockings.
- Use drugs from the group of phlebotonics, angioprotectors. With the development of inflammatory processes, antibacterial drugs can be prescribed. Painkillers are used to relieve pain.
- If sutures have been applied, they can be removed 7 days after the procedure.
- If the patient is overweight, it should be brought back to normal to reduce the load on the veins.
- It is recommended to give preference to loose clothing made of natural fabrics and comfortable shoes. Wearing high heels is contraindicated.
- At home, try to keep your legs elevated with rollers or pillows.
The rehabilitation phase can last up to several weeks, during which the patient is placed on a special illness.
Modern methods of removing varicose veins have a rehabilitation period of just a few days, but they are more expensive than usual.
In the future, the patient must come for a second examination and undergo an additional examination so that the doctor assesses the effectiveness of the treatment.
operations costs
Phlebectomy is performed both in public clinics and in plastic surgery centers to eliminate aesthetic defects.
Patients are interested in how much varicose vein surgery costs.
It all depends on the clinic and the qualifications of the doctor performing the procedure, as well as the degree of development of the disease and the complexity of the proposed operation. Not the last place in pricing is given to the city and region in which the patient wants to perform the procedure.
For reasons of cost, some clinics include a preoperative examination and a rehabilitation phase.
Expert forecasts
Conducting the combined phlebectomy procedure does not exclude the possibility of recurrence of the disease. After the use of radical treatment methods, recurrence of varicose veins is possible due to the physiological characteristics of the body (the structure of blood vessels and veins) or a violation of the technique of performing the procedure (if the doctor was unable to normalize the patency of the affected vein). The risk of renewed exacerbation of the disease is observed in about 15-20% of cases. In the event that the patient finds manifestations of repeated recurrence of the disease, a doctor should be consulted as soon as possible.
Only an experienced specialist will help you suggest the right operation to remove varicose veins and give useful recommendations that must be followed during the recovery period. If you do not consult a doctor on time, the consequences can be the most deplorable and irreversible.