Removal of veins in the lower leg is referred to as a radical treatment method. Surgery to remove varicose veins in the legs can be prescribed to the patient if the use of conservative and alternative methods of therapy does not have the right therapeutic effect and the disease continues to progress.
With advanced forms of varicose veins, surgery can solve the following problems:
- Eliminates pathological reflux (reverse flow) of blood.
- Keep the saphenous vein portion disease -free and healthy.
- Remove the affected area of the vein.
Before surgery, the doctor marks the vein under ultrasound control, which allows you to determine the extent of the affected segment. Removal of the affected vessel and portion of the vein is performed using a narrow probe, which is inserted through a small incision. After the affected area is removed, the risk of recurrent disease is low.
After surgery to remove varicose veins, the chances of recurrence of the disease are low.
In modern medicine, they prefer the combined procedure of phlebectomy, which involves the use of several techniques at once.
The main stages of radical combination treatment are: upper or lower crossectomy, short stripping, perforated vein ligation, mini-phlebectomy.
In the early stages of the disease, any of the listed procedures can be used as an independent operation. In some cases, as an alternative to some of the classic combined phlebectomy stages, minimally invasive treatment methods in the form of sclerotherapy or laser removal may be offered.
Type of operation
The common name for surgery to remove the affected vein is phlebectomy. Modern types of these procedures:
- The implementation of a stripping procedure (long or short) is the most gentle technique, in which the doctor can only remove a certain part of the affected vein. This procedure is performed through a small incision along the vein.
- The implementation of laser phlebectomy is a modern method of treatment that involves the use of lasers. Thanks to this tool, the laser freezing process takes place in the affected vessels. The procedure is performed under local anesthesia and does not require the use of special surgical instruments. The laser is injected into the vein together with a small diameter catheter, then under the influence of the pulse a small vapor bubble is formed, which affects the vessel wall. As a result, the affected vein becomes part of the tissue and no longer bothers the patient.
- Endoscopic removal of the affected vein. In this case, an endoscope is inserted into the venous area, and the doctor can personally analyze the condition and the extent of its damage. In the future, the surgeon has the opportunity to cut the affected area.
The so -called seamless technology is very popular, when the affected venous area is removed through a small incision. Already 4-6 hours after manipulation, the patient can walk freely. If the development of trophic disorders is observed, then endoscopic equipment is used.
Advantages of the miniphlebectomy method
Miniphlebectomy is one of the least painful and non -traumatic surgical methods to remove an affected vein. The procedure is performed in three stages: diagnosis, a small incision with a scalpel at the site of the affected blood flow, extraction of the affected area on the vein.
The operation is performed under local anesthesia, the recovery period does not take much time from the patient. Scars, bruises not formed at the puncture site, pain interrupted in isolated cases.
Miniphlebectomy is an almost painless way to get rid of varicose veins, the recovery period after surgery is minimal.
To minimize the risk of bruising and bruising, surgery can be performed using tumescent anesthesia, which, in addition to anesthetics, includes substances that have a vasoconstrictive effect. After the procedure, the patient was discharged after a few hours, while there were no features of general anesthesia intoxication, as well as pain.
Crosssectomy
The concept of "crossectomy" means the ligation and subsequent crossing of a small or large saphenous vein. As an independent operation, such a procedure can be carried out only in case of emergency, when there is a risk of spread of the acute form of thrombosis.
To date, there are gentler alternative procedures for crossectomy - performing endovasal laser ablation and radio frequency ablation.
The advantages of the technique are: the possibility of refusing general anesthesia, outpatient treatment, the absence of cosmetic defects in the form of scars from incisions and scars.
Among the disadvantages, one can notice a higher probability of recurrence of the disease and a relatively high cost for this procedure.
Exercise
Surgery for lower extremity varicose veins is performed after the initial examination of the patient and the implementation of internal examination.
The following types of examinations can be given:
- Foot vein ultrasound.
- General blood analysis.
In the future, physicians will conduct oral surveys to identify possible contraindications to surgical intervention. Preliminary examination allows you to choose the optimal type of surgical procedure or, if necessary, combine several well -known methods at once.
It is very important that the patient understands how to behave properly before and after the procedure. Prior to surgery, it is recommended to refrain from taking medications, including acetylsalicylic acid, because of the risk of bleeding. On the day of the operation, there is no need to prepare the procedure carefully - you just need to remove the hair in the area of the operated limb.
When is surgery needed?
Patients wondering whether surgery is necessary for varicose veins in the lower leg should understand that such a radical method of therapy is needed in the following cases:
- The rapid development of the disease, which is accompanied by intense pain.
- Development of varicose thrombophlebitis 1-4 degrees.
- Strong feeling of heat and burning in the vein area.
- Spread of varicose veins above the kneecap.
- The formation of swollen veins, not aesthetically pleasing.
This operation is also indicated for the formation of long -term incurable tropical disorders (ulcers), for which conservative therapy does not have a proper therapeutic effect.
Contraindications and possible consequences
It is mandatory to take into account possible contraindications and consequences of surgical intervention.
Surgical intervention should not be performed if the patient has a history of diseases such as hypertension, cardiac arrhythmias, coronary heart disease, the presence of infectious diseases in the acute stage, dermatological inflammatory diseases of the feet.
Surgery should not be performed at the end of pregnancy, as well as in elderly patients with weakened immunity.
Patients should take into account the possibility of complications, as well as the consequences of surgical intervention:
- Violation of the sensitivity of the operated limb due to damage to the nerve endings.
- Momentary or persistent numbness in the ankle area.
- Formation of suppuration.
- Development of bleeding with varying intensity.
- Re -education of bulging veins in places above or below the scar after surgery.
- Pain syndrome does not affect all patients and occurs if nerve endings have been affected. Normalization of sensitivity in most cases occurs independently, without the use of any medication.
- Hematomas and bruises at the surgical site may be bothersome. In this case, drugs from the anticoagulant group for topical use can be prescribed. If the patient has very delicate and sensitive skin, then the effects of bruising can last for 1-1. 5 months.
- The development of edema may indicate that the patient does not follow the doctor’s instructions, does not adhere to a rest regime and exposes the body, including the lower limbs, to excessive physical effort.
Strictly adhere to the doctor's recommendations, it depends on how long the consequences of the operation will last.
Therefore, before deciding whether it is worth performing surgery for varicose veins, you should take into account all possible risk factors: carefully weigh the pros and cons. Surgery should be performed in cases where the manifestations of the disease bother the patient for a long time and worsen the quality of life.
It is also necessary to consult only with experienced and qualified doctors who perform such operations: phlebologists, angiosurgeons.
Recovery period
After surgery, patients are recommended to follow all the instructions of the attending physician so that the recovery period takes the shortest possible time and you can return to your normal lifestyle quickly. During the first 48 hours, patients are strictly prohibited from:
- Consumption of alcoholic beverages.
- Motor transport management.
- Take a shower in the hot tub.
- Excessive physical activity.
In the first few days after surgery, there may be complaints of pain in the legs, as well as an increase in body temperature. In this case, the method of medical therapy is involved, physiotherapy is prescribed. The patient should not always be in a horizontal position. You need to walk a little every day to restore blood flow.
In the future, the implementation of the following recommendations also minimizes the risk of developing complications after this surgery.
- Hydroprocedures, massage, therapeutic exercises and other physiotherapy methods, to be prescribed by the attending physician. Such a procedure prevents the formation of blood clots, normalizes the outflow of blood.
- In the first few months, both limbs need to be re-rolled with 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 a suture has been used, it can be removed 7 days after the procedure.
- If the patient is overweight, then 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, you should try to raise your legs using rollers or pillows.
The recovery period can take up to several weeks, during which patients will be given special sick leave.
Modern methods of getting rid of varicose veins involve a recovery period of only a few days, but it is more expensive than usual.
In the future, the patient must come for a second examination and undergo additional examinations so that the doctor evaluates the effectiveness of the treatment.
Operation cost
Phlebectomy is performed in public clinics and in plastic surgery centers, the purpose of which is to remove aesthetic imperfections.
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 on the stage of disease progression and the complexity of the proposed operation. Not the last place in the formation of the price is given to the city and region where the patient intends to perform the procedure.
Some clinics include preoperative examinations, as well as recovery periods, for cost reasons.
Forecasts from experts
The implementation of a combined phlebectomy procedure does not exclude the possibility of recurrence of the disease. After the use of radical treatment methods, recurrence of varicose veins may be due to physiological features of the body (structure of blood vessels and veins), or violation of the technique of performing the procedure (if the doctor is unable to normalize the patency of the affected veins). The risk of disease recurrence is observed in about 15-20% of cases. If the patient records recurrent manifestations of the disease, one should see a doctor as soon as possible.
Only an experienced specialist will help you properly recommend surgery to remove varicose veins to choose from, as well as provide useful recommendations that need to be followed during the recovery period. If you do not consult a doctor in a timely manner, the consequences can be the most tragic and irreversible.