Varicose veins or varicose veins, these formulations in phlebology mean pathology accompanied by modification, that is, deformation of the veins.The vessels that carry blood to the heart dilate, lengthen, their walls thin and the functioning of the venous valves is altered.
If the first stage of varicose veins is treated very effectively with conservative methods, then the progression of the disease to stages 2 and 3 can only be cured surgically;Medications and other methods can only stop the progression of pathology.This article will discuss the main surgical methods of treating varicose veins, the features of their implementation, etc.
Indications for surgery
Because in the first stage of the development of varicose veins, surgical intervention is very rarely performed due to lack of necessity, the indications for surgery are a very important factor.The decision is based on the data obtained during a detailed vascular diagnosis and is 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 rehabilitation after surgery, which are subsequently carried out only with the consent of the patient.
As for the indications themselves, varicose vein surgery is necessary in the following cases:
- Pathological expansion and subsequent deformation of purely saphenous veins of the second degree of severity and higher.
- Extensive forms of varicose veins, the disease affects not only the subcutaneous veins, but mainly the deep ones, or the deformation of the vessels extends to too large an area of the lower extremities.
- A serious circulatory disorder occurs, accompanied by worsening blood stagnation.
- Severe forms of swelling, high intensity pain, accompanied by different external (aesthetic) signs of varicose veins.
- Formation of trophic ulcers on the skin or subcutaneous hematomas due to disruption of the integrity of blood vessels;
- Progression of the pathological process up to blockage of venous vessels and the development of an acute form of thrombophlebitis.
- Lack of positive dynamics during conservative treatment, that is, when medications and other methods of combating varicose veins are powerless.
Restrictions and contraindications for surgery.
Unfortunately, even if severe forms of varicose veins develop, accompanied by complications and a serious clinical picture, the patient cannot always undergo surgery.
There are a number of contraindications that, although they do not completely exclude the possibility of surgical intervention, force the operation to be postponed for a certain period of time:
- Coronary 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, it is necessary to deal with the infection or eliminate the inflammation.
- Second and third trimester of pregnancy: For pregnant women, it is best to postpone any surgical procedures until the woman gives birth.The only exceptions are those cases where there is a serious danger to the life of the mother or child and surgery can help.
- Skin disease in the area of surgery to combat varicose veins.We are talking about eczema, various forms of dermatoses, etc.
- There are also certain age restrictions, of course in the case of older people.In some cases, advanced age, as well as the accompanying senility diseases, increase the risk of developing postoperative complications or endanger a person's life 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 confident in the need for surgical intervention, all that remains is to choose the most appropriate and effective method, depending on the degree of progression of varicose veins and other factors.To understand what operations exist and in what cases they are performed, we will consider the most effective methods of surgical treatment of varicose veins.
combined phlebectomy
A complete operation that is performed under general anesthesia and can last up to 2 hours, depending 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 severely progressed.
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 on a larger area, for example, in the groin.Often these incisions are shallow, as primarily superficial veins are removed.
The principle of the operation is to ligate the anastomosis of the vessel and then remove the part of the vein affected by varicose veins.Additionally, during surgery, the surgeon can correct the venous valves to restore normal blood flow.
At the end of the operation, cosmetic stitches are placed in the incisions, 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 can be considered purely cosmetic.The idea is that the doctor makes a small puncture in the skin, through which he extracts the part of the vein that needs to be cut.This operation is performed mainly on small vessels and its advantages include painlessness (due to local anesthesia) and a minimal recovery period.
Sclerotherapy
A relatively new technique, a minimally invasive method, which is famous for its effectiveness, as well as the absence of pain due to the same local anesthesia and a practically non-existent rehabilitation period.
The procedure involves the introduction of a special substance into the lumen of the vein - a foam sclerosant.This substance causes the walls of the container to collapse and subsequently stick together.As a result, the vein stops participating in the blood circulation process, gradually resolves and is replaced by connective tissue.
The sclerotherapy technique is mainly used to eliminate small superficial vessels, as well as to eliminate the so-called “spider veins.”
Laser coagulation
The most modern and, according to many experts, effective way to combat varicose veins.Its essence lies in the fact that a laser light guide is inserted into the venous lumen through a hole of only 2 millimeters.When the latter is activated, it begins to emit laser waves, the temperature inside the vessel increases, and when the laser is removed, the walls of the vein collapse and stick together.Subsequently, the vessel disappears on its own and is 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 gentlest operation leaves certain traces and can have consequences.First of all, this is due to the fact that the anatomical component of the body is removed - a complete glass.Of course, with combined phlebectomy, these consequences can be much more serious than a couple of bruises after laser coagulation.
Let's consider the most basic consequences that periodically arise after one or another type of surgical treatment:
- When removing varicose veins using minimally invasive methods that exclude the removal of vessels, there is a risk of relapse.This risk is minimal during laser coagulation, only 5%.
- Burns - occur after operations during which thermal effects were used.
- Bleeding: can begin after any type of intervention, but is more likely after a phlebectomy.
- There are also known cases of nerve damage, but this factor is related only to the level of professionalism of the surgeon.
Rehabilitation process
Rehabilitation, that is, recovery after surgery, is necessary in each of the described cases, but if after coagulation this process lasts only a couple of days, then after combined phlebectomy it can last several weeks.To ensure that the recovery goes smoothly and quickly, it is important to follow simple recommendations:
- Strictly follow all your doctor's advice.
- Wear compression garments or elastic bandages.
- If there have been incisions, it is important to wait for them to heal.
- Once the incisions have healed, it is important to restore physical activity;Exercise therapy and regular walks will help with this.
- If your doctor prescribes any medication, take it 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 intense physical activity.
If the operation went well and the patient fully complied with all the doctor's instructions regarding 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, varicose vein prevention should always be carried out if cases of the development of this pathology have occurred.