Varicose veins or varicose veins, these recipes in phlebology are pathological, ie vascular deformation, accompanied by modification. The arteries that carry blood to the heart dilate, lengthen, thin the walls, and disrupt the function of the venous valves.
If the first stage of varicose veins is treated very effectively with conservative methods, the transition to stages 2 and 3 of the disease can be treated only with surgery, drugs and other methods can only stop the development of pathology. This article describes the main surgical methods for the treatment of varicose veins, application features, etc.
Tips for surgery
Due to the lack of need in the early stages of varicose veins development, surgery is a very important factor for surgery. The decision is based on the information obtained during the detailed diagnosis of blood vessels and is made by the patient and the doctor.
The phlebologist has to talk about the risks of the proposed operation, the duration and nuances of postoperative rehabilitation, which are then carried out only with the consent of the patient.
As for the indicators themselves, in such cases, varicose vein surgery is required:
- Pathological dilation and subsequent deformation of pure saphenous veins of the second degree and higher.
- Wide forms of varicose veins, the disease affects not only the sapenosis, but also the deep veins, or the deformation of the veins extends to many parts of the lower extremities.
- There is a serious circulatory disorder accompanied by aggravated stagnant blood processes.
- Severe forms of edema accompanied by different external (aesthetic) symptoms of varicose veins, high-intensity pain syndrome.
- Formation of trophic ulcers on the skin or subcutaneous hematomas due to violation of vascular integrity;
- Progression of the pathological process to venous occlusion and the development of acute thrombophlebitis.
- Lack of positive dynamics during conservative treatment, ie when drugs and other methods to combat varicose veins are weak.
Restrictions and contraindications for operation
Unfortunately, with the development of severe forms of varicose veins, accompanied by complications and a severe clinical picture, it is not always possible for such a patient to undergo surgery.
There are a number of contraindications that can force you to postpone surgery for a period of time unless they completely rule out the possibility of surgery:
- Ischemic heart disease - in this case it is necessary to conduct a more thorough examination.
- The same applies to grade 3 hypertension.
- Active infectious and inflammatory processes in the body - To treat varicose veins, it is necessary to cope with the infection or eliminate the inflammation before performing an operation.
- 2nd and 3rd trimesters of pregnancy - it is better for pregnant women to postpone any surgery until the woman gives birth. The only exceptions are cases where there is a serious threat to the life of the mother or child and surgery can help.
- Skin disease in the area of surgery to combat varicose veins. From eczema, various forms of dermatosis, etc.
- Of course, there are certain age restrictions for adults. In some cases, old age and concomitant diseases increase the risk of postoperative complications or endanger the life of a person on the operating table.
Methods of surgical intervention in varicose veins
Again, if the doctor is convinced that surgery is needed based on the diagnosis and after examining the patient, it remains to choose the most appropriate and effective method, depending on the degree of development of varicose veins and a number of other factors. To understand what operations are performed and in what cases, we will consider the most effective methods of surgical treatment of varicose veins.
Combined phlebectomy
A complete operation performed under general anesthesia and lasting up to 2 hours, depending on the complexity of the task. Phlebectomy can be used to treat primary forms of varicose veins, but this method is more commonly used in advanced cases when the disease is severe.
During the operation, the surgeon makes an incision of up to 2 centimeters for the ankle or up to 5 centimeters in a wider area, such as the groin. Often these incisions are narrow because most of the superficial veins are removed.
The principle of the operation is to close the anastomosis of the vessel with the subsequent removal of the affected part of the vessel from the varicose veins. Also, during the operation, the surgeon can adjust the venous valves to restore normal blood flow.
After the operation, cosmetic sutures are applied to the incisions, the bandage is straightened and an elastic bandage is applied to the operated area to prevent bleeding.
Miniflebectomy
During this procedure, the affected area of the vein is also cut, but the scale of the operation is smaller, it can only be considered cosmetic. The bottom line is that the doctor makes a small hole 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 the advantages are painlessness (due to local anesthesia) and minimal recovery period.
Sclerotherapy
A relatively young technique, known for its effectiveness and the absence of painful sensations due to the same local anesthesia and virtually no rehabilitation period, is a minimally invasive method.
The procedure involves the insertion of a special substance into the vascular lumen - foaming sclerosant. This substance causes the walls of the vessel to collapse with subsequent adhesions. As a result, the vessel ceases to participate in the circulatory process, gradually dissolves and is replaced by connective tissue.
Sclerotherapy is mainly used to remove small superficial veins and at the same time get rid of "spider veins".
Laser coagulation
It is the most modern and effective way to fight varicose veins, according to many experts. Its essence is that the laser light guide enters the venous lumen through an opening of only 2 mm. When the latter is activated, the laser waves begin to propagate, the heat inside the artery rises, and as the laser is removed, the artery walls collapse and stick. The vessel then disappears on its own and is replaced by connective tissue.
Of course, the main advantage of this procedure is that the visible lesions on the skin are almost complete and there is no need for rehabilitation.
Possible results
The most delicate operation leaves such traces and can lead to consequences. First of all, this is due to the removal of the anatomical component of the body - a full-fledged vessel. Of course, with combined phlebectomy, such results can be more serious than a few caries after laser coagulation.
Let's look at the main results that occur from time to time after a particular surgical treatment:
- There is a risk of recurrence when varicose veins are removed using minimally invasive methods, except for vascular removal. This risk is minimal only during laser coagulation, only 5%.
- Burns - occur after operations in which thermal effects are applied.
- Bleeding - can begin after any intervention, but most likely after phlebectomy.
- There are also cases of nerve damage, but this factor applies only to the level of professionalism of the surgeon.
Rehabilitation process
In each of the cases described, rehabilitation, ie recovery after surgery, is required, but if this process takes only a few days after coagulation, it may take several weeks after a combined phlebectomy. It is important to follow simple tips for a smooth and fast recovery:
- Follow your doctor's advice carefully.
- Wear compression garments or elastic bandages.
- If cuts have occurred, it is important to wait for them to heal.
- It is important to restore physical activity after the incisions have healed, and exercise therapy and regular walks will help.
- If your doctor prescribes any medication, take it according to these instructions.
- It is also useful to visit a masseur after surgery and to prevent varicose veins.
- Avoid severe physical suffering for at least 2-3 months.
If the operation went well and the patient followed the doctor's instructions, there is a good chance of a favorable result. In most cases, varicose veins can be treated, but this does not mean that the disease will not affect other veins. Therefore, if there are cases of development of this pathology, prevention of varicose veins should always be carried out.