Almost every person with this disease has to deal with the removal of veins with varicose veins. Even in the early stages of the disease, vessels appear that cannot be restored with conservative methods. Then, patients start thinking about how to remove varicose veins from their legs forever. Unfortunately, the operation will not be able to completely stop the progression of the disease. To stop the disease, you will have to adjust your lifestyle and take care of the vessels. When removing varicose veins, doctors achieve a significant improvement in the patient's condition: the edema, the pain, the weight on the legs disappear.
Instructions for operation
Removal of varicose veins is not indicated for all patients. Of course, there are women and men who are dissatisfied with the vascular bumps under the skin. They prefer to remove the veins for aesthetic reasons. But most patients do not decide this step on their own, but are referred for surgery by a doctor. The indications for surgery are as follows:
- severe swelling of the limbs;
- change in the color and structure of the fabrics;
- the appearance of trophic ulcers that do not heal;
- regular exacerbations of thrombophlebitis;
- strong increase in saphenous veins;
- pain in the limbs.
Although many patients are afraid of this operation, it is not harmful to the body. If the surgical intervention is performed with 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 asks for surgery?
The direction of the operation is given by the phlebologist, but the vascular surgeon is specifically involved in the development of a plan for the surgical treatment of varicose veins. He carefully examines the patient, evaluates the condition of the venous valves using hardware research methods. If the external veins are affected, radiofrequency obliteration or sclerotherapy can be dispensed with. With deep varicose veins, phlebectomy will be necessary.
How much does an operation cost to treat varicose veins?
The surgical intervention is performed in a day hospital or in a department specialized in vascular surgery. In state institutions, if the assistant physician is referred, the operation is free. The cost of surgical treatment of varicose veins in private clinics varies. There is no maximum cost limit, as 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 some categories of patients due to the tendency to bleeding and thrombosis. With coronary heart disease and a recent stroke, the veins should not be removed. This will increase stress on the cardiovascular system. The patient must first recover and then undergo a second exam. The list of contraindications for surgery includes:
- arterial hypertension 3 and 4 degrees;
- II and III trimesters of pregnancy;
- the presence of inflammation in the legs, including eczema;
- infectious limb injuries;
- age over 70 (requires a complete health check);
- damage to the deep veins of the extremities (consultation with several surgeons and resection of the altered vessel is necessary, if possible).
How to prepare for surgery?
A few days before surgical treatment of varicose veins, the patient must undergo 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 do other tests. On the morning of the operation it is necessary to bathe, remove the excess vegetation from the leg that is going to be operated. In addition, preoperative preparation before removing varicose veins includes:
- test the patient's sensitivity to analgesics and anesthetics;
- control ultrasound examination.
On the eve of the operation, it is advisable to limit yourself to a light dinner. It is best not to drink 3-4 before surgery. There are also some contraindications, depending on the type of anesthesia the doctor decides to use.
Types of operations
Venous preservation surgery for varicose veins is currently possible. All patients who decide to undergo an operation should be aware of this. Today, doctors are developing a way to eliminate varicose veins while preserving the saphenous vein. The main problem with this technique is that it is not suitable for all patients. Surgical intervention in a group of volunteers showed that it would not be possible to preserve the vessel with advanced varicose veins.
With the help of some methods, you can remove the varicose veins in parts, that is, excision of the affected vein and suture your healthy areas. But this approach to the treatment of the disease must be approved by the vascular surgeon, since not all patients have veins that can recover normally. Most of the time, the following methods of removing varicose veins are used in surgical practice:
- mini phlebectomy;
- radio frequency obliteration;
- laser co-regulation.
This procedure is the removal of the saphenous veins. With crossectomy, all tributaries of the vein are first connected and then stopped. The pot is removed along with the branches. The incision is made in two locations. This technique is used to operate patients at risk for thrombosis.
The difference between this operation and the classic one is that the punctures are made on the surface of the legs, instead of incisions. The operation is less traumatic for the patient, but has some disadvantages. Not all veins can be removed through punctures, and not all patients have them. If the patient has an extensive 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 means of a small puncture on the skin. Removal is usually part of a phlebectomy. The incisions themselves are subtle. Its length rarely exceeds 1 cm. The advantages of this technique include a short recovery period. After 2 weeks, the patient can return to his normal way of life.
This procedure consists of injecting a specialized sclerosing substance into the affected vessel. The affected vein sticks, the blood flow stops, the varicose veins decrease. This operation is performed if it is necessary to eliminate vessels of small length and diameter. The sclerosant cannot blind the large veins. After a while, they are restored and blood begins to circulate through them again.
Radio frequency obliteration
This method was developed to replace classic vascular surgery. The technique consists in the fact that a directed radiofrequency wave acts on the walls of the vessel, sealing it. After a while, blood stagnation is eliminated and blood flow is normalized. Before starting the vein treatment, the following parameters are entered into the device:
- vein diameter;
- the necessary level of hot exposure.
This approach to the operation allows you to completely eliminate lesions in the surrounding tissues and adjacent vessels. Disposable materials are used for the operation. After the operation, the punctures are disinfected and, if necessary, sutured (if the bleeding does not stop). The patient can go home 4 to 5 hours after surgery.
This method of removing varicose veins is considered the most modern and least traumatic. Doctors do not make an incision in the tissues, so patients cannot be concerned with the aesthetic component of the legs. The skin is punctured in a specific location. A laser light guide is inserted through the hole, which evaporates the damaged vessel. One of the advantages of laser coagulation is the low number of recurrences. Only 5% of patients seek vascular removal after laser treatment.
How is the operation performed?
The first step in any surgery is to anesthetize the surgery 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 only a small vein, apply local conduction or anesthesia. The next sequence of actions depends on the type of operation being performed. 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 orifice or several additional incisions are made along the entire length of the vein.
- The vessels are sealed or allowed and removed.
- The sites where the vein was connected to other vessels are sutured.
The characteristics of rehabilitation after the removal of a vein in the leg with varicose veins depend on the body of a specific patient and the type of surgical intervention. 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 must comply with the following recommendations:
- Always wear compression clothing. In the first few weeks after surgery, it should not be removed, even before bedtime.
- Do not lift weights over 10 kg.
- Take venotonic medications daily.
- Come for the exams on the scheduled dates.
- Do gymnastics.
- Do not take hot baths, do not visit baths and saunas.
A light massage can speed up the recovery of the legs. There is no need to go to a specialist for it. You can massage your legs independently with light pressure movements. Permission for other restorative procedures must be given by a doctor.
Possible complications after surgery
After surgery, some patients have negative consequences. Complications develop in people with a genetic predisposition to thrombosis and blood clotting problems. It is normal to have bruises up to 1 month after surgery. The most common complications are:
- loss of sensation in the legs due to nerve damage during surgery;
- profuse 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 of varicose veins develops more frequently due to the genetic tendency of the patient's capillaries to accumulate lymph. Although its appearance is not very unpleasant, this liquid is not dangerous for the patient. In about 90% of cases, it dissolves on its own, and only 10% of patients have to suck it up. Care with the Seroma suture is the same as for normal skin lesions.
The removal of varicose veins in the legs without consequences occurs in 96% of patients. In the first few days, you may feel mild pain, but then they will go away. The patient should exclude fatty and unhealthy foods from his diet. In the postoperative period, the patient's main task, in addition to recovery, is to keep the veins in good condition. This requires:
- refuse from bad habits;
- observe a regime of rest and work (even at work and even if you have to stand / sit constantly, don't forget the warm-up);
- reduce your caffeine intake;
- monitor posture;
- maintain the normal body mass index;
- choose comfortable shoes and clothes.
The first place is occupied by morning and afternoon gymnastics. Exercises in this group will help to relieve leg fatigue, strengthen blood vessels, ligaments and tendons. You also need to take daily walks outdoors. Ideally, a person should walk at least 8 km a day. If you find it difficult to overcome this distance at once or do not have enough time, you can reduce it to 3 km.