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Surgical treatment of varicose veins
Surgical treatment of varicose veins
At present, surgical treatment of varicose veins is one of the key. However, it should just mention that surgical treatment is indicated, not all patients with varicose veins.
If you are pregnant or have given birth, it is recommended to wait at least 6 weeks before you consider surgery, as in most cases, varicose veins, which arose during pregnancy and resolves on its own without any intervention.
If you suffer from varicose veins are cosmetic side (eg, spider veins on the legs), and no other manifestations such as pain or inflammation of the veins, the surgery - not the best method of treatment in this case, since there is much less invasive, but no less effective methods of treatment.
Surgical treatment is indicated in cases where conservative treatment and lifestyle changes do not resolve the symptoms of varicose veins.
Most surgical treatments for varicose veins can be treated as outpatients. That is, the patient should not be constantly in the hospital after surgery and can go home immediately.
Surgical procedures include procedures such as ligation (ligation of the vein) or stripping.
Any surgery carries a risk of complications, so we need to discuss this fact in advance with your doctor. Even surgery does not guarantee against recurrence of varicose veins in the future.
Stripping
Stripper - a minimally invasive intervention, which struck Vienna is removed using a small thin probe. At the same time is usually two small incision - one in one end of varicose veins, the second - on the other end. After Vienna naked, she meets in these two places, and in the lumen of the tube e is introduced. The head of the probe is fixed (thread) to the end of the vein (ie, at the point the vein, whence came the probe). Next, the surgeon pulls the probe for this vein.
Typically, stripping is carried out to remove the vein from the groin to the knee-pits, or pits from knee to ankle.
The advantage of stripping - is that this is not carried out a long incision along the veins, and only cuts in the beginning and end of the vein. Thus, there is a cosmetic effect of stripping.
In the currently used short stripping. Short stripping differs in that the removal is carried out with only the affected parts of varicose veins. And Vienna with the saved, the normal valve remains intact. This reduces the duration of surgery, trauma and improve cosmetic effect.
One of the advantages of short-stripping are more rapid recovery period and the almost complete absence of pain in the postoperative period.
Ligation
Ligation is the ligation of varicose veins. Usually ligature techniques are not applied separately, but only in addition to the other - phlebectomy, stripping.
The indications for ligature techniques and stripping
Typically, stripping is performed for removal of large varicose veins. In addition, this method of intervention used to prevent trophic changes of the skin in the form of ulcers. Suitable stripping is usually:
When the treatment of varicose veins is carried out for cosmetic reasons and you do not have other health problems.
Have you noted swelling and the severity of the legs, especially after prolonged standing. When bleeding from varicose veins.
In the event of venous ulcers, which indicates the presence of chronic venous insufficiency.
If you have both small and large varicose veins may require more than one treatment. Typically, stripping large varicose veins sclerotherapy supplemented by smaller venous branches.
Who should not stripping?
Ligation and stripping contraindicated:
Elderly patients who have an increased risk of postoperative complications,
Patients with impaired blood flow in the arteries of legs
Patients with impaired lymph flow (lymphedema), infectious skin lesions or thrombus,
Pregnant women,
Patients with arteriovenous fistulas.
Stripping efficiency
Stripping efficiency in terms of eliminating the symptoms of varicose veins and prevent its recurrence is 9 out of 10 patients.
Stripping of varicose veins can prevent recurrence of venous ulcers. According to studies, patients who are used to prevent formation of trophic ulcers of compression therapy, 28% of cases, there is another ulcer. If compression therapy combined with a stripper, the risk of trophic ulcers of only 14%.
Complications of stripping
Among the complications of stripping can be noted scarring of the incision site (although very small, when done correctly, surgery) and recurrence of varicose veins. In addition, in violation of patency of deep veins stripping can cause deterioration of the venous outflow in the leg. That is why before any intervention in the veins of the legs performed a thorough investigation of deep vein patency using Doppler ultrasound. Other complications of operations, as with other interventions, it may be noted infectious complications, bleeding and the risk of anesthesia.
Anesthesia
Stripping operation may be performed under local or general anesthesia.
What you need to know
Previously, doctors believed that an undesirable stripping on the grounds that if the suddenly ill ever need an aorto-coronary bypass surgery, then Vienna on foot can be used as a shunt. However, currently there is the view that varicose veins may not be complete shunts for such an operation. In addition, in most cases, this operation may play a role shunt thoracic artery, and in addition, for this purpose can be taken from the veins of his hands.
Mikroflebektomiya (miniflebektomiya)
Miniflebektomiya - an operation in which varicose Vienna is removed through a puncture in the skin. Miniflebektomiya operation - it's minimally invasive surgery that requires anesthesia for a minimum.
Miniflebektomiya carried out using a special hook that is inserted under the skin of varicose veins through the smallest incision, puncture. This hook is pulled out varicose Vienna, after which she tied up and overlap. Further, in the same way done removing all the other veins.
It should be noted that the removal of veins in this way (and stripping) leads to the formation of varicose veins in place of bruises (hematoma). But do not worry, because they disappear after 2-3 weeks after the application of ointments (such as heparin or Lioton). Puncture site remains virtually invisible scars.
Among the advantages of miniflebektomii worth noting the high efficiency, low invasiveness and ability to work virtually full preservation of the patient, and, of course, an excellent cosmetic effect.
After the miniflebektomii (and stripping) on the operated leg is put on compression stockings. Your doctor will tell you how long you will need to wear this jersey. Many doctors advise after surgery as much as possible to walk or ride a bike.
Transluminal phlebectomy (TIPP)
Transluminal phlebectomy - a minimally invasive procedure to remove varicose veins. For this method, a system TriVex ®. This is a unique technique, which is based in the fact that under the patient's skin along the varicose vein is entered with a thin zondik bulb on the end. This allows the doctor to see her veins and that its plot, which is removed surgical instrument. In traditional miniflebektromii doctor does not see itself vein and can not confirm its removal, that is working "blindly".
This operation is performed under local anesthesia in a darkened room. Two small puncture a vein under the flexible tube is introduced with a cold source of light (xenon). Injected under the skin of a special liquid that separates the vein from surrounding tissue and provides anesthesia. Next is found the second tool, which is induced by light. Vienna is drawn by suction into the hole in the skin and a special blade is cut into two parts, which are then extracted.
The duration of the operation is about half an hour. To puncture the skin does not impose any seams, and only aseptic patch.
