Treatment of varicose veins. Classical phlebectomy, laser treatment. What to choose?

Duplex scanning of vessels (veins) of the lower leg

Treatment of varicose veins on the legs with medication is far from always effective. It is very difficult to cure varicose veins if it is at an advanced stage. In this case, surgery is the only option to get rid of the disease. Classical phlebectomy, mini-phlebectomy, sclerotherapy, laser vein removal are effective methods to solve the problem of varicose veins. However, not all women who suffer from varicose veins immediately decide on one of them. Fear of surgeons and operating rooms, fear of general anesthesia and complications stop patients, so they are afraid to see a doctor for a long time, depending on some form of treatment at home. Meanwhile, the varicose veins developed, and the condition worsened.

Will varicose veins "come out" again? Do you need to hide ugly stitches after surgery? Do you really have to wear special knitwear for a year after surgery? These and other questions torment women and remain unanswered, and surgeries necessary for foot health are delayed for months, and often for years. But today, not only is a classic phlebectomy performed, which is a full surgical intervention (with general anesthesia, a long recovery period and return to normal life), but also a mini -surgery on a vein, performed outpatiently, under local anesthesia, and after that does not require long sick leave.

Treatment options for varicose veins

Any surgery listed, whether classic phlebectomy, mini-phlebectomy, laser or sclerotherapy, is prescribed by the doctor taking into account the degree of varicose veins in the lower leg and the patient’s condition. It is not possible to choose the method of removing varicose veins independently, it is determined by the doctor after examination:

  • duplex scans of the ducts (veins) of the lower leg are universal and informative,
  • rarely, in complex diagnostic cases, X-ray contrast phlebography and computed tomography methods are used.

Features of surgical methods for treating varicose veins

Various types of surgery are widely practiced in inpatient and outpatient settings. Each method has its own indications and contraindications, its own pros and cons.

Classical vein removal surgery

Often, the attending physician choosesclassic phlebectomy. . .

The operation is performed under general or spinal anesthesia. During surgery, the large saphenous vein is removed along with the varicose veins. After surgery, you have to stay in the hospital for a few days, then at home for a few weeks. Sutures are removed on days 7-10 after surgery, the healing time is individual.

Advantageclassic phlebectomyvery effective in the treatment of moderate and severe varicose veins. This technique has been used for decades, has proven itself successfully and has enabled millions of patients to maintain the health of their feet.

Among its disadvantages are a long recovery period, deterioration of general well -being after surgery and inability to immediately return to normal routine (work, driving, long walks), as well as inadequate cosmetic effects that last for months.

Mini phlebectomy

Unlike classic surgery, with a mini phlebectomy, removal is performedthe affected veins of the individual superficialthrough various punctures or small punctures. Surgeons use special tools (hooks, mini -scalpels) of small size. These interventions are performed at different stages of the disease and can be combined with other methods (laser removal, sclerotherapy).

Advantages of the method:

  • outpatient surgery, being under the supervision of a physician for several hours after manipulation,
  • local anesthesia,
  • fast healing of punctures and micro punctures, no stitches,
  • the ability to immediately return to a normal routine, as well as an excellent cosmetic effect.

After surgery, several complications may occur - hematomas in the area of incisions and punctures, discoloration of the skin in the area of the vein being operated on, but generally these risks are minimal.

Laser removal

Laser removal of varicose veins(venous endovasal laser coagulation) is a widely used and highly effective innovative method.

During intravascular (endovasal) surgery, a small incision or puncture is made in the skin: under ultrasound control, a long light guide is inserted into the vein through a catheter. Through it, the laser beam acts on the walls of the veins, "attaching" them.

The advantages of this methodis an outpatient operation, under local anesthesia.Laser removal of varicose veinscan be combined with mini-phlebectomy, sclerotherapy, provides an excellent cosmetic effect, which is very important for women of all ages. The catheter insertion site is covered with a special plaster, which is removed after 8-10 days, no sutures are used. After the operation, you can go through a normal rhythm, practically without restrictions.

Compared with classical phlebectomylaser vein removal for varicose veinsconsidered less traumatic and safer.

But it should be noted that this method is not considered universal for the treatment of patients with varicose veins (like others). Performing such an operation, such as classical vein removal, can only be performed after a full examination of the patient, taking into account all the features of the course of the disease.

Choosing a clinic for varicose vein treatment and surgery

The surgeon examines the patient's veins before surgery

Conservative treatment and surgery of varicose veins is carried out today in many public and private medical centers. The clinic you trust your health must have a serious reputation and experienced doctors skilled in a variety of vein surgery techniques.

In high-tech operating room conditions, classical phlebectomy, mini-phlebectomy, sclerotherapy (in various versions), etc. are performed. It is important that the choice of method by the physician is always justified by the clinical picture and discussed with the patient, explaining the pros and cons of the method, the risk of consequences and possible complications. For example, inclinic for the treatment of varicose veinsit is not always recommended to use invasive ("mild") techniques. Contraindications to this: severe varicose veins, thrombophlebitis, blood clotting disorders and others. In this case, a combined operation is performed to achieve good results.

For doctorsclinics dealing with the treatment of varicose veins, the outcome of therapy and the patient’s condition are very important - both at the beginning and end of the postoperative period. That is why surgeons are always in touch and ready to answer any questions of interest to the patient being operated on.

Phlebologist's advice

While there are options for surgical techniques to remove varicose veins and the possibility of minor patient intervention, any surgery requires a period of recovery and a careful attitude towards one’s health. Therefore, from the first appointment to the end of postoperative medical supervision, everythingrecommendation of a phlebologist:

  • first of all, wear a medical jersey; special underwear is worn immediately after surgery, after phlebectomy. The first two days, as a rule, it is recommended to wear knitwear at all times. Next, wear it daily for 3-6 weeks (according to the doctor's instructions);
  • after endovasal intervention (laser therapy), which is not combined with other methods, compression therapy is not required, in the case of combined surgery, application is required for one or two months. For the first two days, the knitwear was left overnight.
  • othersrecommendation of a phlebologistrelated to physical activity and a healthy lifestyle, control of excess weight and changes in working conditions, if involving prolonged static load on the legs. You need to walk for 40-60 minutes every day. You can add special exercises to strengthen your veins and blood vessels for daily walks. For the first two months after surgery, do all physical exercises in compression gowns. Remove the squat and lift weights (dumbbells, barbells) from the complex. Also, don’t put too much pressure on the lower abdomen.

In general, the most important condition for successful varicose vein correction is the cooperation of doctor and patient. Trust in the attending physician, adherence to all his recommendations and subsequent adherence to preventive rules contribute to the preservation of the health and beauty of the feet.

03.07.2021