Almost all carriers of this disease have to deal with the removal of veins with varicose veins. Even at an early stage of the disease, vessels appear that cannot be restored using conservative methods. Then the patients begin to think about how to permanently remove varicose veins from their legs. Unfortunately, the operation will not be able to completely stop the progression of the disease. To stop the disease, you will have to adapt your lifestyle and take care of the vessels. By removing varicose veins, doctors achieve a significant improvement in the patient's condition: edema, pain, heaviness in the legs disappear.
Indications for the operation
Removal of varicose veins is not indicated for all patients. Of course, there are women and men who are unhappy with vascular bumps under the skin. They prefer to remove the veins for cosmetic reasons. But most patients do not decide this step on their own, but are sent for surgery by a doctor. The indications for surgery are as follows:
- severe swelling of the limbs;
- change in color and structure of tissues;
- the appearance of non-healing trophic ulcers;
- regular exacerbations of thrombophlebitis;
- a sharp increase in saphenous veins;
- pain in the limbs.
Despite the fact that many patients are afraid of this operation, it is not at all harmful to the body. If the surgery is carried out with the help of modern instruments and techniques, the patient will recover very quickly. Of course, removal of the vein is prescribed if drug treatment does not work at all.
Who orders the surgery?
The direction of the operation is given by the phlebologist, but the vascular surgeon is specifically involved in developing a plan for the surgical treatment of varicose veins. He carefully examines the patient, assesses the condition of the venous valves with the help of hardware research methods. If the external veins are affected, radiofrequency obliteration or sclerotherapy may be removed. With deep varicose veins, a phlebectomy will be necessary.
How much does an operation cost to treat varicose veins?
The surgery is performed in a day hospital or in a specialized vascular surgery department. In public institutions, if recommended by the attending physician, the operation is free. The cost of surgical treatment for varicose veins in private clinics varies. There is no maximum cost scale because hospitals offer a wide range of services.
Although the removal of varicose veins is considered a universal method of treating the disease, not everyone can undergo the procedure. It is contraindicated in certain categories of patients due to a tendency to bleeding and thrombosis. With coronary artery disease and a recent stroke, the veins should not be removed. This will increase the stress on the cardiovascular system. The patient must first recover and then undergo a second examination. The list of contraindications to surgery includes:
- arterial hypertension 3 and 4 degrees;
- Trimesters II and III of pregnancy;
- the presence of inflammation on the legs, including eczema;
- infectious lesions of the limbs;
- age over 70 years (requires a thorough examination of the state of health);
- damage to the deep veins of the extremities (consultation of several surgeons and resection of the damaged vessel, if possible).
How to prepare for surgery?
A few days before the surgical treatment of varicose veins, the patient must pass general and biochemical tests. The tendency of the blood to form blood clots should be checked. If everything is in order, you will not need to take any further tests. The morning of the operation, you must take a shower, remove the excess vegetation from the leg that will be operated. In addition, the preoperative preparation before removing varicose veins includes:
- test the patient's sensitivity to pain relievers and anesthetics;
- control of ultrasound examination.
The day before the operation, it is advisable to limit yourself to a light dinner. It is better not to drink 3-4 before the surgery. There are also contraindications, depending on the type of anesthesia the doctor decides to use.
Types of operations
Venous surgery for varicose veins is currently possible. All patients who decide to have an operation should be aware of this. Today, doctors are developing a way to remove varicose veins while preserving the saphenous vein. The main problem with this technique is that it is not suitable for all patients. Surgery on a group of volunteers showed that it would not be possible to preserve the vessel with advanced varicose veins.
With the help of certain methods, you can remove varicose veins in parts, ie. i. e. excise the affected vein and suture its healthy areas together. But this approach to treating the disease must be approved by the vascular surgeon, as not all patients have veins that can recover normally. Most often, the following methods of removing varicose veins are used in surgical practice:
- mini phlebectomy;
- radio frequency obliteration;
- laser coogulation.
This procedure is the removal of the saphenous veins. With crossectomy, all tributaries to the vein are first ligated and then stopped. The vessel is removed with the branches. The incision is made in two places. This technique is used to operate on patients at risk of thrombosis.
The difference between this operation and the conventional operation is that punctures are made on the surface of the legs instead of incisions. The operation is less traumatic for the patient, but there are some drawbacks. Not all veins can be punctured, and not all patients have it. If the patient has a large network of capillaries or vessels, this method cannot be used.
This surgical method is considered minimally invasive. During the operation, only the affected part of the vein is removed, and the vessel remains completely. All manipulations are carried out by a small skin puncture. Stripping is often part of a phlebectomy. The incisions themselves are subtle. Their length rarely exceeds 1 cm, and the advantages of this technique include a short recovery period. After 2 weeks, the patient can return to his usual way of life.
This procedure involves injecting a specialized sclerosing substance into the affected vessel. The affected vein sticks together, blood flow stops, varicose veins recede. This operation is carried out if it is necessary to remove vessels of small length and small diameter. The sclerosant cannot blind the large veins. After a while, they are restored and blood begins to flow through them again.
This method was developed as a replacement for classic vascular surgery. The technique consists in the fact that a directed radiofrequency wave acts on the walls of the vessel, sealing it. After some time, the stagnation of the blood is eliminated and the blood flow is normalized. Before starting venous therapy, the following parameters are entered into the device:
- diameter of the vein;
- the required level of heat exposure.
This approach to the operation allows you to completely eliminate injuries to surrounding tissues and adjacent vessels. Disposable materials are used for the operation. When the operation is complete, the punctures are disinfected and, if necessary, sutured (if the bleeding does not stop). The patient can go home 4 to 5 hours after the surgery.
This method of removing varicose veins is considered the most modern and least traumatic. Doctors do not make an incision in the tissue, so patients may not be concerned about the aesthetic component of the legs. The skin is pierced at a specific place. A laser light guide is introduced through the hole, which evaporates the damaged vessel. One of the advantages of laser coagulation is the low number of relapses. Only 5% of patients require vascular ablation after laser treatment.
How is the operation performed?
The first step in any surgery is to numb the surgical site. Epidural anesthesia for varicose veins is indicated if the area to be treated is large. The patient will be constantly awake, but motor activity will be completely disabled. If you need to remove a single small vein, apply conduction or local anesthesia. The sequence of actions depends on the type of operation in progress. The general outline of the surgical intervention is as follows:
- Before the operation, the vessels are isolated, which must be removed.
- The doctor makes an incision at the base of the vein.
- Special devices are inserted through the hole or several additional incisions are made along the length of the vein.
- The containers are sealed or cleared and removed.
- The places where the vein was connected to other vessels are sutured.
Features of rehabilitation after removal of a leg vein with varicose veins depend on the body of a particular patient and the type of surgery. Immediately after all manipulations are completed, elastic bandages will be attached to the leg. They cannot be removed for several hours. Until the end of the postoperative period after varicose veins, the patient should adhere to the following recommendations:
- Wear compression garments at all times. During the first weeks after surgery, it should not be removed, even before bedtime.
- Do not lift more than 10 kg.
- Take venotonic medication every day.
- Come take the exams on the dates set.
- To practice Gymnastique.
- Do not take hot baths, do not visit baths and saunas.
A light massage can speed up the recovery of the legs. It is not necessary to go to a specialist for him. You can massage your legs independently with gentle pressure movements. Authorization for further restorative procedures must be given by a physician.
Possible complications after surgery
After surgery, some patients experience negative consequences. Complications develop in people with a genetic predisposition to thrombosis and blood clotting problems. It is normal to have bruising and bruising if it happened up to 1 month after surgery. The most common complications are:
- loss of sensation in the legs due to nerve damage during surgery;
- heavy bleeding;
- painful swelling of the leg at the site of the operation;
- numbness in the lower leg;
- the appearance of pus in the hematoma.
Seroma after treatment for varicose veins most often develops due to the genetic tendency of the patient's capillaries to accumulate lymph. Despite its unpleasant appearance, this liquid is not dangerous for the patient. In about 90% of cases, it dissolves on its own and only 10% of patients need to suck it. The care of Seroma sutures is the same as for normal skin lesions.
Removal of varicose veins on the legs without consequences takes place for 96% of patients. The first few days you may feel a little pain, but then it will go away. The patient should exclude fatty and unhealthy foods from his diet. After the operation, the main task of the patient, in addition to recovery, is to keep the veins in good condition. It needs:
- refuse bad habits;
- observe a regime of rest and work (even at work and even if you constantly have to stand / sit, do not forget about a warm-up);
- reduce your caffeine intake;
- monitor posture;
- maintain a normal body mass index;
- choose comfortable shoes and clothing.
The first place is occupied by the gymnastics of the legs in the morning and in the evening. Exercises in this group will help relieve fatigue in the legs, strengthen blood vessels, ligaments and tendons. You should also introduce daily walks in the great outdoors. Ideally, a person should walk at least 8 km per day. If you find it difficult to cover such a distance at once or if you don't have enough time, you can reduce it to 3 km.