Varicose veins or varicose veins, these formulations in phlebology means pathology accompanied by modification, ie deformation of the veins. The blood vessels that carry blood to the heart dilate, lengthen, the walls become thinner, and the function of the venous valves is disrupted.
If the first stage of varicose veins is very effectively treated by conservative methods, then the progression of the disease in the 2nd and 3rd stages can be cured only by surgery, medication and other methods to stop only the progression of the pathology. This article focuses on the main surgical methods of treatment of varicose veins, the peculiarities of their implementation, etc. Sh.
Indications for surgical intervention
Given that surgical intervention in the first stage of varicose vein development is very rare due to lack of need, it is a very important factor to refer to surgery. The decision is based on the data obtained during the detailed diagnosis of blood vessels and will be taken by the patient in consultation with the physician.
The phlebologist is responsible for the risks, duration of rehabilitation, and nuances of the proposed surgery after surgery, which are then performed only with the patient's consent.
As for indications, varicose vein surgery is required in such cases:
- Second degree severity abnormal dilatation and subsequent deformation of the sacral vein. Wide forms of varicose veins, the disease affects not only the final but mainly the deep veins, or the deformation of blood vessels extends to a very large area of the lower extremities.
- is a serious circulatory disorder accompanied by deteriorating stagnant processes in the blood.
- Severe forms of edema, high-intensity pain syndrome accompanied by distinct external (aesthetic) signs of varicose veins.
- Development of trophic ulcers or subcutaneous hematomas on the skin due to violation of vascular integrity;
- Progression of the pathological process to the blockage of venous blood vessels and the development of an acute form of thrombophlebitis.
- Lack of positive dynamics during the period of conservative treatment, ie when medications and other methods of solving the problem of varicose veins are powerless.
Operation limitations and contraindications
Unfortunately, even with the development of severe forms of varicose veins, accompanied by complications and a severe clinical picture, the patient is not always able to have surgery.
There are a number of contraindications that, if they do not completely rule out the possibility of surgery, require postponement of surgery for some time:
- Ischemic heart disease - in this case a more complete comprehensive examination is needed.
- The same goes for grade 3 hypertension.
- Active Infectious and Inflammatory Processes in the Body - Before treating varicose veins, you need to deal with the infection or eliminate the inflammation.
- 2nd and 3rd trimester of pregnancy - it is better for pregnant women to postpone any surgical procedure until the woman gives birth. The only exceptions are cases where the life of the mother or child is in serious danger and surgery can help you.
- Skin disease in the area of varicose vein surgery. We are talking about eczema, various forms of dermatosis and so on. Sh.
- There are also some age restrictions, of course, for the elderly. In some cases, old age as well as concomitant senile diseases increase the risk of postoperative complications or endanger the life of the person on the operating table.
Methods of surgical intervention for varicose veins
If, nevertheless, the doctor is convinced of the need for surgery on the basis of diagnosis and examination of the patient, it remains to choose a suitable and effective method from the degree of progression of varicose veins and many other factors. To understand what surgeries are 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 performed under general anesthesia and can last up to 2 hours, depending on the complexity of the task. Phlebectomy can be used to treat the initial forms of varicose veins, but more often this method is used in advanced cases when the disease is severely progressing.
During surgery, the surgeon makes an ankle length of up to 2 cm or a larger area up to 5 cm, such as the groin. Often, these incisions are shallow because mostly superficial veins open.
The principle of surgery is ligation of the vessel anastomosis with subsequent removal of part of the vein affected by varicose veins. Also, during surgery, the surgeon can adjust the venous valves to restore normal blood circulation.
At the end of the operation, cosmetic sutures are made on the wound, a bandage and an elastic bandage are made at the surgical site to prevent bleeding.
Miniphlebectomy
This procedure also removes the affected area of the vein, although the scale of the operation is smaller, it can be considered as a cleaner cosmetic. The conclusion is that the doctor makes a small puncture in the skin through which he separates the part of the vein that needs to be cut. This operation is mainly performed on small vessels and its advantage is painless (due to local anesthesia) and minimal recovery period.
Sclerotherapy
A relatively young technique, a minimally invasive method known for its effectiveness, as well as the absence of painful sensations due to the same local anesthesia and is practically no rehabilitation period.
The procedure involves the introduction of a special substance into the venous lumen - foam sclerosant. This substance causes the vessel walls to disintegrate with their subsequent adhesion. As a result, the vein ceases to be involved in the bloodstream, gradually disintegrating and being replaced by connective tissue.
The method of sclerotherapy is mainly used to remove small superficial vessels, as well as e. g. წ. To get rid of "spider veins".
Laser coagulation
The most modern and, according to many experts, effective remedy against varicose veins. Its essence is that the laser light guide is inserted into the venous lumen with an opening of only 2 mm. When the latter is activated, it begins to emit laser waves, the temperature rises inside the vessel, and as soon as the laser is removed, the walls of the vein collapse and bind together. Subsequently, the vessel disappears by itself, being 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 surgery leaves a mark and can lead to consequences. First of all, this is due to the fact that the anatomical component of the body has been removed - the full-fledged vessel. Of course, with combined phlebectomy, such consequences can be much more serious than a few bruises after laser coagulation.
Consider the most basic results that appear periodically after this or that surgical treatment:
- There is a risk of recurrence when minimizing varicose veins using minimally invasive methods other than vessel removal. This risk is minimal only during laser coagulation, only 5%.
- Burns - occur after operations that use thermal effects. Bleeding - can start after any type of intervention, but is more likely after a phlebectomy. Cases of nerve damage are also known, but this factor only applies to the level of professionalism of the surgeon.
Rehabilitation process
Each case described requires rehabilitation, ie recovery after surgery, but if this process takes only two days after coagulation, then it may take several weeks after combined phlebotomy. In order for recovery to proceed smoothly and quickly, it is essential to follow simple recommendations:
- Follow your doctor's advice carefully.
- Wear compression garments or elastic bands.
- If wounds have occurred, it is important to wait for them to heal.
- After the wound has healed, it is important to resume physical activity, exercise therapy, and regular walking.
- If your doctor prescribes any medication, take it according to these instructions.
- It is also helpful to visit a masseur after surgery and for the prevention of varicose veins.
- Avoid strenuous physical activity for at least 2-3 months.
If the operation went well and the patient followed the doctor's instructions about 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, prevention of varicose veins should always be performed if there have been cases of development of this pathology.