What is the best surgery for varicose veins?

This question is often asked by patients who have already decided to get rid of varicose veins or spider veins through surgery. But they have a poor idea of which leg vein surgery is said to help better, what kind of complications occur in the postoperative period.

In fact, there are not so many types of operations, they can be divided into "small", which is performed through a small puncture in the skin, and "big", when the diseased vein on the leg is excised (pulled out ) completely. Let's find out in which cases serious surgical intervention is required, and when a minor operation will help.

Surgery for varicose veins

Laser photocoagulation, also known as EVLK, also known as EVLO and also known as EVLA

If the diameter of the varicose vein is small, you may be offered laser photocoagulation (or in other words EVLT - endovascular laser photocoagulation). Its principle is as follows: a "ladder" with a laser emitter at the end is inserted into the vein. After turning on the laser, it is moved in the direction from top to bottom, as it moves along the vein, it "sticks" together. After the operation, the patient is forced to walk for about 40 minutes with a special compression stocking. This is done so that the blood is redistributed and begins to flow through other veins.

The diseased vessel treated with the laser gradually dissolves, leaving no traces. The consequences of such an operation are beautiful, not disfigured by "clusters" of varicose veins, legs. But we must remember that varicose veins are a chronic disease, that is, no one excludes the possibility of recurrence of another vein. Any surgeon will tell you about it, they don't hide it.

Laser coagulation for varicose veins

Another thing is that there is a lot you can do yourself to slow down the process: wear compression underwear, do special exercises, just walk a lot. After all, varicose veins often develop where there is little movement and blood congestion.

Sclerotherapy as another "office" operation

Why "office"? Yes, because you can return to your office right on the day of the manipulation. For example, they demanded a longer hospital stay for all minor surgical interventions that did not require general anesthesia.

The principle of sclerotherapy is the same as with laser, except that the vein is "glued" with a special sclerosing glue. There is also foam sclerotherapy, in which the sclerosant is whipped into foam just before the manipulation. This fills the lumen of the vesselbetter from. However, there are contraindications to foam sclerotherapy, such an intervention is especially dangerous in the presence of cardiac pathology, a defect associated with the "oval window" - there is a risk of foam getting into the heart through the venous system.

Sclerotherapy is not performed if there is a tendency to thrombosis (the same applies to laser treatment), if you have high blood pressure, or if you are pregnant. But most of the patients who underwent this procedure have positive feedback, they say that the legs began to hurt and get tired less, and the cosmetic effect is visible immediately and one can only rejoice.

Surgery to remove large veins - phlebectomy

Phlebectomy - complete removal of a varicose vein

Venous disease doctors - phlebologists - in some cases do not consider it possible to perform small operations. Therefore, there is a list of indications for phlebectomy (complete removal of the vein):

  • common varicose veins;
  • enlarged vessels of large diameter;
  • Swelling and severe fatigue in the legs, even without visible varicose veins;
  • complications of varicose veins, such as thrombophlebitis and trophic ulcers;
  • Swelling and fatigue in the legs with pronounced varicose veins.
Phlebectomy for varicose veins

Modern techniques make it possible to make the operation of phlebectomy minimally traumatic for the patient. In addition, this operation has variants:

  1. Crossectomy (when the saphenous vein is crossed exactly at the point of its confluence with the deep vein in the thigh).
  2. Safenectomy is a classic operation to remove subcutaneous vessels.
  3. Stripping - when only the changed part of the vessel is removed with a probe.
  4. Microphlebectomy - With a hook, it is removed through small punctures.

As you can see, the choice is quite large. As a rule, the surgeon uses several methods, for example, he combines phlebectomy with sclerotherapy to remove both a large vein and small dilated vessels at the same time.

What to do after a phlebectomy?

After a "major" surgical intervention on the veins, the patient is put on a compression stocking, the removal of which is not recommended for 3 days.

Stockings after varicose vein surgery

Mandatory exercise therapy, dosed walking. A light massage is also prescribed. No heavy loads and sports are allowed. Thermal procedures are also excluded (bath and pool are still prohibited). Bruises and seals can remain on the leg for some time, do not be afraid, they will pass in a couple of weeks.

The stitches are removed after about a week, but doctors recommend wearing compression underwear for at least a month. Of course, you can take pictures, but not for long - to wash yourself, so that the leg "rests" a little.

And now - watch the video about phlebectomy, the girl talks about her illness, a conversation with the doctor and the choice of surgical intervention.