Surgical (surgical) treatment of varicose veins: is it necessary to have an operation and what kind? Removal of the GSV How is surgery on the veins of the legs performed?

Varicose veins are a disease in which the walls of the vessels of the deep veins narrow and blood flow slows down.

This disease has become much younger in our time. This occurs due to a sedentary lifestyle (although constant work on your feet can provoke an outbreak of the disease), movement only by transport, excess weight, environmental situation in the world, genetic predisposition to blood diseases, etc.

The early stage responds well to conservative treatment methods. But if the disease has already gone far and continues to progress, then you should think about an operational way to solve the problem.

A vein removal operation correctly performed by a qualified surgeon is a guarantee of complete recovery from a debilitating, debilitating disease.

Today, such operations are carried out by highly qualified specialists in medical centers equipped with the most modern equipment, and do not pose any danger to the life and health of the patient.

Indications for surgery

Vein removal is used in the following cases:

• extensive, covering a large area of ​​the vein;
• improper expansion of the saphenous veins;
• severe swelling and rapid;
• pathological disturbance of blood outflow in the veins;
• and vein blockage.

Restrictions and contraindications

The operation is not prescribed in the following cases:

• advanced state of varicose veins;
• stage 3 hypertension and coronary heart disease;
• severe inflammatory and infectious processes;
• old age;
• 2nd and 3rd trimesters of pregnancy;
• skin diseases in the acute stage (eczema, erysipelas, dermatitis, etc.)

Before the operation, a thorough examination of the patient’s venous system, as well as an extensive examination, is carried out. Emergency surgery is prescribed for vein blockage, recurrent thrombophlebitis and non-healing trophic ulcers.

Methods of surgical intervention

Leg vein removal surgery can be performed using several modern techniques.

Phlebectomy is popular

In the early stages of the disease it is carried out. Preparing for this species operations are the most basic. The patient takes a shower and completely shaves his leg and groin.

It is very important that before surgery the skin on the leg is completely healthy and skin not violated. Before the operation, the patient’s intestines are cleansed and tests are carried out for allergic reactions to medications.

The operation lasts up to 2 hours under local anesthesia. Removal of the saphenous vein is absolutely safe for the human body. During the operation, extravasal correction of the valves may be performed to restore blood outflow.

The operation begins with an incision up to five cm long in the groin and two cm long at the ankle. The remaining incisions are made under large venous nodes. The cuts are shallow and not wide.

A venous extractor (in the form of a thin wire with a round tip at the end) is inserted into a vein through an incision in the groin. Using this instrument, the surgeon removes the damaged vein. The incisions are then sutured and the operation is considered complete.

Of course, the leg is covered with a sterilized bandage and an elastic bandage is applied on top. After 1-2 days the patient can already move independently.

After phlebectomy, the patient wears (or) for 2 months, and also takes it to restore the functioning of the veins.

In some cases, it is prescribed, in which case small incisions are made on the leg (under local anesthesia), through which the damaged parts of the vein or even the entire vein are removed.

Sclerotherapy - painless removal of varicose veins

Today, treatment of varicose veins with injections has become especially popular. In this case, a substance called sclerotant is injected into the vein. which destroys the inner layer of the vessels, after which the middle layers grow together and form a prolapsed vein.

This method is the most gentle, but to obtain a lasting effect, several procedures must be performed and it will take about six months for rehabilitation.

This kind surgical intervention, and can also be used only for damage to veins of small diameter and with a large number of “”. A foam-forming sclerotant is injected into the vein, the effectiveness of which increases due to a large increase in the area of ​​interaction with the inside of the vessel.

And in addition, due to its special consistency, the foam lingers in the vessel for a long time, increasing the time of exposure of the drug to the affected vessels. Therefore, with foam sclerotherapy, the number of sessions is reduced significantly.

Laser in phlebology

The most modern method of removing veins is with a laser, this is intravascular. The surface of the vein is treated from the inside with a laser through a barely noticeable puncture. From high temperature laser, the blood instantly boils and seals the wall of the problematic vessel along its entire length.

The huge advantage of this operation is the impossibility of infection, the speed of execution and the rapid healing of venous ulcers. But such an operation requires sophisticated equipment and highly qualified specialists, which are not available in every medical center.

The newest method of seamless technology is very interesting. Using micropunctures, affected areas of veins and vessels are removed. In this case, no stitches are even required. In this case, a sterile elastic bandage is applied to the leg and after five hours the patient can walk independently.

Both of these methods are considered low-traumatic and painless. The patient can, if desired, go home the same day on his own feet.

Possible consequences

After any, even the most gentle operation to remove veins on the legs, there will be bruises, hematomas and other consequences that will bother you for some time.

It is best to sleep with your legs elevated for some time after surgery to improve blood flow.

A fairly common complication after surgery is re-development if the patient has a birth predisposition and has not changed his lifestyle.

It is extremely rare for an adjacent vessel or nerve to be damaged during surgery. But this complication is completely excluded by a qualified specialist. After phlebectomy, small, unnoticeable scars will remain on your legs.

Thromboembolic complications are very dangerous

Thromboembolic complications are the most terrible consequence of the postoperative period. And to warn them, it is necessary carry out a number of preventive measures:

• It is mandatory to wear ;
• wearing elastic bandages for quite a long time with insufficient interaction of the valve apparatus of the deep veins;
• alternate physical activity evenly to eliminate the possibility of blood stagnation;
• the use of special blood thinners to reduce blood clotting.

For a long time I was afraid to have surgery, although varicose veins bothered me a lot and had been for a long time. There was a whole bunch of veiny lumps hanging on my right leg. My leg hurt a lot, it was twisted, especially at night, and she quickly got tired under exertion.

The doctor immediately suggested it. Seeing no other choice, I agreed. And now I don’t regret it at all and even wonder why I hesitated and suffered for so long. The operation was performed by an experienced specialist under local anesthesia.

Seven incisions were made on the leg from the groin to the ankle. Then for two days my leg hurt very badly, but soon the pain subsided and after a week I was discharged from the hospital in good condition.

For a month, I smeared my leg and wrapped it with an elastic bandage, and also took. Now it’s been five years since the surgery and my leg doesn’t bother me at all. No new venous nodes are formed. I advise you not to hesitate in such an important matter, but to agree to surgical intervention.

Yuri V, 49 years old

From the age of 13 I was engaged in shaping and at 26 a whole bunch of venous nodes formed on my leg. My leg hurt incredibly. Nothing helped. When I went to see the doctor, he told me that the disease was in an advanced state and recommended surgery. There was nothing to do and I agreed.

The operation lasted more than an hour under local anesthesia, it was difficult, but the surgeons supported me and distracted me with conversation. A day later I left the clinic. A month later, after several visits to the doctor, the leg became completely healthy, without any traces of disease.

The only thing I regretted was that I did not have this operation earlier. My leg doesn’t bother me at all, although I have had a large vein completely removed. By the way, the stitches from the operation are not visible at all. I urge everyone who is recommended for such an operation to do it and not think twice.

Anna B, 27 years old

Rehabilitation after surgery

Recommendations for the postoperative recovery period will be strictly individual for each patient and will depend on the severity of the disease, the general condition of the patient, the presence of other chronic conditions, etc.

But there are some tips that are common to everyone:

Vein removal operations are well developed and performed by qualified specialists. Very often, ordinary fear prevents us from deciding to have an operation, but is it better to endure the pain and prolong the illness?

If you listen to the advice of your attending physician and follow all his instructions, the postoperative period will pass without complications, and you will be free of your disease forever.

From this article you will learn: what a miniphlebectomy is, for what diseases this operation is performed, how to prepare for its implementation. Technique of miniphlebectomy and course of the postoperative period.

Article publication date: 06/19/2017

Article updated date: 05/29/2019

Miniphlebectomy is a minimally invasive surgical procedure in which surgeons remove varicose veins through small incisions or punctures in the skin.

Click on photo to enlarge

Compared to traditional phlebectomy, this surgical intervention is characterized by a better cosmetic effect and the absence of large scars, and can be performed on an outpatient basis and under local anesthesia. This procedure is sometimes called an outpatient phlebectomy.

Miniphlebectomy is performed by vascular and general surgeons.

Indications for outpatient phlebectomy

Miniphlebectomy is performed to eliminate varicose veins. This operation is used specifically to remove the most varicose veins, and not to remove all saphenous veins.

Contraindications and limitations of outpatient phlebectomy

Miniphlebectomy is performed to remove varicose veins; it cannot be used to eliminate the cause of this disease - venous insufficiency and increased pressure in the superficial saphenous veins. Therefore, miniphlebectomy is often combined with other methods of treating varicose veins - saphenous veins.

This operation is performed with caution when varicose veins are localized on the dorsum of the foot, ankle and popliteal region. These places are more sensitive to trauma, and the veins located in them are more difficult to remove.

Contraindications to miniphlebectomy include:

• Infectious process at the site of surgery.
• Severe peripheral edema.
• The patient has a severe general health condition, for example, decompensation of diseases of the cardiovascular or respiratory systems.
• Patients who have poor blood clotting, for example, due to taking anticoagulants (warfarin, Xarelto) or the presence of certain diseases (hemophilia).
• Patients with increased blood clotting, who have an increased risk of developing venous thrombosis.
• Deep vein thrombosis.
• Pregnancy.

Preparing for surgery

Before performing outpatient phlebectomy, a detailed examination of the venous system using ultrasound methods is necessary. A minimum laboratory and instrumental examination is also carried out to assess the patient’s general health. Tests often recommended by doctors include:

• general blood test;
• general urinalysis;
• coagulogram (test for blood clotting);
• electrocardiography.

Instructions for proper preparation to miniphlebectomy:

1. If you are taking blood thinners (warfarin, Plavix, Xarelto, Brilinta, aspirin), tell your doctors. You may need to stop taking them 5 to 7 days before surgery.
2. If you are allergic to any medications (especially local anesthetics), you should tell your doctors.
3. Since this surgery is not performed under general anesthesia, you should have a light breakfast the morning of surgery.
4. Wear loose clothing and comfortable shoes on the day of surgery.
5. Sometimes doctors give special recommendations - for example, the use of ointments or tablets before surgery. You must follow these instructions carefully.
6. Arrange for a relative or friend to drive you home after surgery. Although the pain syndrome after miniphlebectomy is not severe, it may slightly interfere with free movement and driving.
7. Shave the surgical area the evening before your miniphlebectomy.
8. On the morning of surgery, take a hygienic shower.
9. On the day of surgery, do not apply any oils, lotions, creams, or ointments to the surgical area.

Execution technique

Miniphlebectomy is often performed on an outpatient basis. Despite being minimally invasive, this surgical intervention is performed in operating rooms equipped with all the instruments necessary to provide emergency care in the event of complications.

Immediately before surgery, surgeons often mark with green paint or a marker all the varicose veins that need to be removed. In this case, the patient should stand so that they can be better seen.

The skin at the operation site is treated with antiseptic solutions, then covered with sterile linen. Local anesthesia is then administered, after which surgeons use a small scalpel or thick needle to make incisions or punctures in the skin over the varicose veins. Using special surgical hooks, doctors separate the vein from the surrounding tissue and bring it out through the incision. Using a clamp, the surgeon “winds” the vein onto it, slowly pulling it out of the subcutaneous tissue, and then crosses both ends of the vessel. During miniphlebectomy, the ends of the removed vein are not ligated; bleeding is stopped using compression during and after surgery. After removing one varicose node, move on to the next one.

Typically, the small incisions or punctures in the skin through which surgeons remove varicose veins do not need to be sutured.

An experienced vascular surgeon performs a miniphlebectomy on both lower extremities in 1–2 hours. At the end of the operation, the leg is washed from residual blood, and a sterile bandage is applied to the incision or puncture sites. After this, the lower limb is bandaged with an elastic bandage, which provides sufficient compression of the tissues and prevents possible bleeding.

Postoperative period

Even if your miniphlebectomy was performed as an outpatient procedure, you will have to stay at the facility for about 2 hours before you can go home. In the postoperative period, you should carefully follow the doctor's recommendations and the schedule of control visits to the medical institution.

Physical activity after surgery:

• On the day of surgery, it is important to start walking a little. To do this, you need to get up for at least 5 minutes every hour. On the second day, take short walks of 15 minutes 2-3 times. This will help reduce the risk of deep vein thrombosis and improve blood flow in the legs.
• For the first 48 hours while the bandage is on your legs, elevate your legs in a sitting or lying position at least 3-4 times a day. Standing for a long time in the first days after surgery can cause swelling and discomfort.
• Within a few next days gradually return to daily activities.
• You can resume moderate-intensity aerobic exercise (walking, jogging, yoga, Pilates) 4–5 days after surgery if you feel comfortable doing so.
• You can fly by plane or take long trips (more than 2 hours) after 1 week.

Care of dressings and wounds after surgery:

• During the first 48 hours, the bandage should not be removed or wet. If it feels too tight, elevate your leg to reduce swelling. If discomfort persists, call your doctor.
• After 48 hours, the bandage should be removed, after which you can shower.
• You will need to wear compression stockings for 2 weeks after surgery, removing them only just before bed.
• For 2 weeks after surgery, you cannot immerse your operated leg in water - that is, no baths, swimming pools, etc. You can only take a shower.

Possible post-operative problems:

1. Bruising and discomfort are normal after a miniphlebectomy. They disappear 3-4 weeks after surgery.
2. To relieve discomfort or pain, you can take a pain reliever, such as ibuprofen. Continue taking this medication for 5 to 7 days after surgery to reduce inflammation.
3. Usually, during a miniphlebectomy, no sutures are placed on the skin; small incisions or punctures in the skin heal completely within 2 weeks.
4. After the procedure, you may notice a few lumps that may be tender to the touch. Don't worry, they occur in a third of patients after miniphlebectomy. These are segments of residual veins with superficial thrombi, which are not dangerous and disappear over time. Massage them and apply warm compresses to them several times a day. If these lumps hurt, take ibuprofen for 1 to 2 weeks.
5. If you notice blood oozing under the bandage, apply pressure to the area with two fingers and lie down with your leg elevated. If bleeding continues, call your doctor or call an ambulance.
6. If there is significant bleeding, fever, signs of infection, or any other problems, call your doctor or go to the nearest emergency room.

Prognosis and results of miniphlebetomy

If a miniphlebectomy is performed for the correct indications, the long-term results of this operation are excellent. Success rates for this surgery reach 90% or more. Such good results are usually associated with the elimination of venous insufficiency before performing a miniphlebectomy. It is widespread to first perform radiofrequency or laser ablation of large superficial saphenous veins, and only then perform a miniphlebectomy.

As with any treatment, new varicose veins may appear over time, especially in patients with a genetic predisposition to the condition.

AND Removal of the great saphenous vein is known to be effective in reducing the recurrence of varicose veins. This procedure is performed mainly using an extractor, which is a fairly long flexible wire made of metal or plastic, which is inserted into the lumen of the vein. A tip is attached to one end of this wire, the size of which significantly exceeds the lumen of the vein. The vein is secured to the wire using a ligature. After dissecting the vein at both ends by means of rigid traction (of course, in the direction opposite to the end to which the tip was previously attached), it can be pulled out from the subcutaneous tissue. It is believed, however, that the use of an extractor is a major cause of hemorrhage and postoperative pain, which may lead to delayed recovery of mobility.
S. Khan et al. , Clatterbridge Hospital in Babington/Wirrel, Merseyside, UK, conducted a prospective, randomized comparison of two methods for removing the great saphenous vein. Method A is described above: having made an incision directly under the knee, an extractor was inserted after the saphenofemoral anastomosis into the foramen ovale; the great saphenous vein was ligated at its confluence with the femoral vein, and all lateral tributaries in this area were also ligated and crossed. After this, they bandaged the entire leg and closed the wound in the groin area. The intervention was performed in 40 patients using this method. Another 40 patients, matched for age and gender, formed group B, in which the following methods were used: surgery of the saphenofemoral anastomosis, as well as removal of varicose veins in the area of ​​the great saphenous vein (patients with varicosities in the area of ​​the small saphenous vein were excluded from this trial) were performed the same as in group A. Removal of the great saphenous vein was carried out differently: from the groin area the vein was pulled taut and blunt separation was performed (using index finger) from subcutaneous tissue; the vein was then weakened below the knee by means of small incisions, after which it was removed. Then they closed all the wounds and bandaged the leg.
Before the intervention, all patients gave informed consent to undergo surgery using one of two methods of random choice. After surgery, they were usually sent home within 24 hours and asked to complete a symptom chart, which included a daily pain score ranging from 0 to 10, as well as data on daily activities such as walking in and around the house, climbing stairs, and walking longer distances. and continuation of normal activities, including work. Patients did not find out what kind of surgery they had undergone until a week later, when the bandages were removed. When measuring the area of ​​subcutaneous hemorrhage, the researchers found significant differences: in group A, the surface area of ​​the hemorrhage averaged 160 cm2, in group B - 56 cm2.
Analysis of symptom registration cards showed that the severity of pain during the entire first postoperative week in group A was significantly higher than in group B; in 1 week average in group A it was equal to 3, while in group B it was 1.
13 out of 40 patients in group A who underwent extirpation of the saphenous vein could not climb stairs, in group B there were 6 such patients; however, activity scores did not differ significantly between the two groups during the first postoperative week. Comparative reopening data for both groups is not provided; it was only found that 76% of the 62 patients still working returned to work within 2 weeks.
Based on the data obtained, the authors give preference to method B, i.e. removal of the vein by dissection instead of extirpation, as it is less painful and produces less hemorrhage.
Obviously, the publication presents only very short-term results, and we cannot judge later recurrences of varicose veins. The authors also fail to note that in many Western hospitals, the great saphenous vein is usually removed entirely, not just the part above the knee.
Complete removal, however, may be completely unnecessary when we're talking about about later relapses; with partial, only proximal removal, part of the vein is preserved, which can be used later for vascular operations, for example for coronary artery bypass grafting. Finally, this publication does not address arguments regarding interruption of incompetent perforating veins that connect the deep to the superficial venous system. Perhaps the authors share the opinion of other researchers that the indications for interruption of perforating veins may be very limited, since R. Bjordal back in 1972 showed that they make only a minor contribution to venous hypertension during walking: when retrograde blood flow is mainly the trunk of the great saphenous vein was disrupted by proximal venous occlusion, venous pressure values ​​at the ankle level remained normal.

Literature:

1. Khan SK, Greaney MG, Blair SD. Prospective randomized trial comparing sequential avulsion with stripping of the long saphenous vein.
2. Keeman JN. Varicosis: toch liever chirurgische verwijdering (?strippen?) van de vena saphena magna. NTvG 1996 14 Dec;140:2492.
3. Bjordal RI. Circulation patterns in incompetent perforating veins in the calf and in the saphenous system in primary varicose veins. Acta Chir Scand 1972;138:251-61.

In some cases, the treatment of varicose veins requires the use of radical treatment methods. One of them is a phlebectomy procedure (an operation to eliminate varicose veins in the legs).

Radical therapy can be used in cases where medication and alternative methods Treatments do not have the desired effect and the disease continues to progress. The essence of the method is complete or partial removal of the affected vein. During the procedure, the following therapeutic effects can be achieved:

• Normalize blood flow.
• Eliminate cosmetic defects.
• Remove not only the vein affected by the disease, but also eliminate pathological blood discharge in the leg area.

Carrying out such a procedure is not considered a serious operation. Modern techniques allow you to perform the necessary manipulations quickly and minimize the risk of developing postoperative complications.

Removal of veins for varicose veins is required in severe cases of the disease:

• The formation of trophic disorders, the development of thrombophlebitis.
• For sensory disorders of the lower extremities.
• With the development of extensive varicose veins.
• With intense manifestations of the disease: a constant feeling of fatigue (even at rest), the development of intense pain syndrome, swelling.
• With pathological expansion of the saphenous veins.

Patients should remember that if proper treatment is not carried out in a timely manner, the consequences can be serious and irreversible.

Preparing for surgery

Before performing surgery, you should definitely consult with doctors of the following specialties: angiosurgeon or phlebologist. The doctor prescribes a preliminary examination: ultrasound, blood test.

Before surgery, you should stop using medicines, the active ingredient of which is acetylsalicylic acid. This precaution helps minimize the risk of hematoma or bleeding during or after the procedure.

The patient’s further task is simple: take a shower and get rid of hair in the area of ​​the operated limb.

Possible contraindications

The procedure is not performed if deep vein thrombosis develops or if there is a persistent increase in blood levels. blood pressure and coronary heart disease, the development of inflammatory diseases in the lower extremities (eczema, erysipelas, pyoderma).

Contraindications to the procedure may be the patient’s advanced age, the second half of pregnancy, the presence infectious diseases in the progressing stage.

If the patient experiences the development of trophic disorders that cannot be treated drug therapy and are not associated with varicose veins, the doctor may cancel the operation.

How is the operation performed?

In modern medicine, the technique of combined phlebectomy is most often used. The procedure is performed under anesthesia. The essence of the method is to carry out the following steps:

• Crossectomy procedures - in this case, the surgeon cuts the saphenous vein at the point where it joins the deep vein.
• Procedures for stripping (removing) the great saphenous vein affected by the disease. The manipulation is carried out using a special device - a small diameter probe. During the manipulation, veins can be removed only in the thigh area, or the great saphenous vein can be removed completely.

In order to minimize trauma to the surrounding soft tissue, the affected vein can be removed through small incisions using a narrow probe. In this case, the process of postoperative scarring is reduced and the risk of hematoma formation is reduced.

If the operation is performed to eliminate cosmetic imperfections, the angiosurgeon performs punctures of no more than 5 mm, resulting in almost invisible scars.

There are methods for removing veins that leave virtually no scars.

If it is necessary to remove a large vein trunk, including from both legs, the doctor will most likely insist on performing a safenectomy procedure - a traditional surgical intervention.

How is the rehabilitation period going?

The recovery process for patients after surgery occurs very quickly. After 2-3 days the patient can be discharged home. The rehabilitation period can take up to several weeks. During this time, the patient is issued a special sick leave. It is necessary to follow all the doctor’s instructions in order to quickly return to your normal lifestyle and not provoke the development of possible complications.

During the first few days after surgery, the patient may notice the formation of bruises and lumps. To eliminate such phenomena, it may be recommended to use Heparin ointment or Lyoton externally.

The patient can be discharged home 2-3 days after the operation

14 days after the removal procedure, the patient will be scheduled for a second examination with the attending physician.

If the recovery process goes well, a follow-up examination will be recommended no earlier than 60 days later. In the future, a repeat ultrasound examination of the veins of the lower extremities will be scheduled to ensure the effectiveness of the operation.

The doctor's instructions may vary for each individual patient. It all depends on a large number of factors: the presence of concomitant chronic diseases, the stage of development of varicose veins, the results of surgical intervention.

• During the first few hours, the patient is strictly not recommended to flex or extend the operated limbs.
• In order to normalize the outflow of venous blood, the doctor may advise raising the edge of the bed by 10 cm.
• 24 hours after the procedure, the patient will be given a dressing. In this case, the use of elastic bandages or compression hosiery is required: both limbs are bandaged from bottom to top to the knees.
• The patient can get up and begin to move only after the dressing has been performed.
• In order to reduce the risk of blood clots, a course of therapeutic massage and physical exercise may be prescribed.

During the recovery period, the patient must wear compression stockings and take medicines prescribed by a doctor. 24-hour use of an elastic bandage or elastic stockings is required for at least 60 days.

After surgery, it is necessary to use an elastic bandage or compression stockings.

In the future, the patient will be recommended moderate physical activity: swimming, cycling, gymnastics. It is recommended to refrain from weightlifting and excessive strength loads. The patient is also not recommended to visit the sauna, take a hot bath, baths, carry heavy objects, abuse alcoholic beverages and smoke.

Will have a positive therapeutic effect contrast shower and baths with the addition of apple cider vinegar, sea salt and essential oils.

The cost of removing varicose veins of the lower extremities ranges from 24,000-26,000 rubles and depends on the degree of development of the disease and the clinic.

Varicose veins are a “middle-aged” disease; it affects both women and men of any age. During the initial development of varicose veins, patients do not attach much importance to the emerging signs. But as the disease progresses, symptoms become more severe.

Which treatment should you prefer?

Varicose veins of the venous vessels of the lower extremities pose a serious threat to the life of the patient.

It can cause dermatitis, the formation of trophic ulcers, and bleeding, which not only make it impossible to work, but also lead to disability. The advanced form is not amenable to conservative treatment.

Varicose veins in the leg give rise to blood clots, which can break off at any time and lead to death. Varicose veins can only be overcome by surgical treatment.

Indications for surgery

Surgical interventions are performed by experienced surgeons if:

Contraindications

There are certain moments when you cannot resort to surgery, including:

In these cases, conservative treatment is used to alleviate the patient's condition. If this initial stage, it is recommended to wear compression garments, which will keep the stretched walls of blood vessels in good shape.

Lotions applied to the affected areas have a positive effect. For this, the following are used: curdled milk, wormwood decoction, hop infusion, alcohol tincture of Kalanchoe, cabbage leaf with honey and others.

Hirudotherapy is successfully used, in which leeches thin the blood with their saliva and thereby help blood circulate through the veins of the legs. Pharmacy ointments, creams, medicinal patches, gels, and medications are prescribed.

But it is important not to miss the onset of the disease, since at a late stage of development, surgery for varicose veins is inevitable.

Protruding nodes on the veins are a consequence of varicose veins.

This happens because the valves on the saphenous vein lose the ability to close tightly, thereby preventing blood flow in the opposite direction.

Modern medicine is able to select its own method of surgical treatment for each patient.

Methods can be combined and the interests of the result respected.

There is only one principle - it is necessary to normalize the blood flow in the leg and prevent the risk of a pathological process.

Preparing for surgery

Phlebectomy requires careful preparation. It is necessary to undergo a full examination of tests and hardware tests.

Before surgery for varicose veins, the patient is given a cleansing enema and all hairs are shaved off the legs.

The patient must inform the doctor about any allergic reactions he has to medications.

Types of surgery

There are several ways of performing surgical intervention, among which there are classic types and innovative ones, using new techniques and equipment.

It was first performed by a Swiss surgeon. A sharp, narrow-tipped scalpel and a large needle are used to penetrate the affected area.

This mini-operation does not require sutures, and the penetration fields are covered with adhesive tape. This is a delicate job that requires a lot of experience and skill from the surgeon.

Excision is performed under local anesthesia. During the intervention, the surgeon makes two punctures through which the dilated venous areas are removed.

Advantages:

• after such an invasion, there are no scars left on the skin;
• gives a cosmetic effect.

The method can be used alone or as part of a larger intervention.

The recovery period is short, leaves no traces and is in demand from an aesthetic point of view. It is recommended to wear compression garments.

Before the operation, an ultrasound duplex scan of the venous tract is performed, and markings are made using phlebography (a contrast agent is injected). Additionally, the results of the biochemical composition of urine and blood are studied.

The essence of the operation consists of subcutaneous pulling out of blood vessels using a metal probe. Incisions are made and the varicose vein is ligated through them. This method is also used in modern medicine.

The varicose vessel is removed in parts using the tunneling method, using suturing of the affected segment of the vessel with catgut.

The aesthetic perception of the skin after such treatment leaves a not very pleasant impression.

Disadvantages of the method:

• spinal anesthesia is performed;
• traumatic and dangerous due to its postoperative period;
• leaves scars after excision.

Short creaking

This is a gentle treatment for varicose veins, which allows you to eliminate the affected segment. Before the operation, the coordinates of the affected vein and the length of the segment are accurately determined. After two small incisions, the affected varicose vein is removed.

The method has its advantages in terms of the recovery period and minimizing injuries.

The equipment allows for most accurate penetration into the walls of blood vessels.

Disposable catheters are used, heating and removal temperatures are controlled.

All pain is minimized.

Advantages of the method:

• allows you to solve problems on both legs at the same time;
• reconstruction can be carried out on veins;
• gives excellent aesthetic results.

Endoscopic vein dissection

The impact is carried out with a special device - an endoscope. It gives a complete picture of the internal damage to the vein.

The peculiarity of the treatment is the use of new technologies that make it possible to implement it into the veins remotely. The endoscope “looks through” the affected segments and selects the desired one.

In addition, the device allows you to determine the edges of the tibia on the lower leg even in the most obese patients.

A low-traumatic method of treatment for venous pathology. During surgery, a light guide is used, inserted into the affected area using an ultrasound scanner.

The laser beam closes the varicose vein and stops its functioning. This is the latest method of combating the disease, recognized throughout the world.

Under the influence of a laser beam, “gluing” of the affected area occurs.

The procedure is performed on an outpatient basis, takes 30 to 45 minutes, and does not require incisions. After surgical treatment, blood does not enter the fused vein and chooses normal venous lines.

Indications for the method

If classical surgical methods are not suitable for the patient due to his health characteristics, laser coagulation is chosen. The method allows you to quickly and permanently get rid of varicose veins without disfiguring your legs with incisions or stitches.

Advantages of laser coagulation:

Contraindications for this method:

How to avoid complications?

Almost any intervention causes certain consequences and complications. An ultrasound will highlight dilated tributaries and prescribe sedatives. Internal vascular treatment will avoid:

• damage to the lymphatic system and nerve ducts;
• injuries to nearby tissues;
• swelling;
• pain;
• loss of sensitivity in the area where the affected vein was removed.

Rules for life after such treatment

Varicose veins after surgery require special attention to prevent relapses or complications on the leg. It is necessary to increase the tone of the venous vessels, for this:

A sedentary lifestyle is contraindicated after surgery. Already in the first postoperative hours, you should sit down and do light exercises for your legs.