In spite of medical advances, surgical treatment is the only way to completely get rid of varicose veins. Therapeutic methods effective only at the beginning of the disease, but they are only supports the nature. Today, minimally invasive operations are performed on an outpatient basis and do not require a long recovery period. And even the traditional phlebectomy is performed through an advanced method.
Varicose veins — if you need an operation?
Varicose veins accompanied by painful symptoms and psychological discomfort, called personal hygiene of defects. And suffer with him in the first place the women. The medicines do not help to restore the stretched, inflamed veins enlarge the functions, especially in 3 and 4 of the stage of the disease. The only possibility of recovering in the legs normal circulation of blood — this is a varicose veins surgery. If you do not remove the rust of vienna, there is no escape from complications such as thrombosis and trophic violations.
Indications for the removal of the veins
The need of the operation, when varicose veins in the legs is determined individually. The choice of the methodology depends on the degree of injury, age of patient, presence of co-morbidities. Has the same value of the weight of the patient. Under any symptoms shown a surgical intervention:
- the pathological process involved a few vessels are much enlarged and form the venous site;
- swollen feet, pain, they leaving spasm;
- interrupted the working valve device and occurs, the current of the venous return of the blood;
- begin changes to trophic — general features acquire crimson-cianótica shadow, becoming dry, they appear as scars, ulcers.
The doctor may decide on the carrying out of the surgery if varicose veins complicated with the different diseases of the blood vessels or other attendant pathologies, such as, for example, sharp thrombophlebitis.
Contra-indications to the operation
Even low-trauma operation does absolutely safe. Before you make a decision the vascular surgeon studies the medical history of a patient in search of against-indications. The surgical treatment is unacceptable when both of the following conditions:
- serious violations of the heart;
- malignant neoplasms;
- diabetes mellitus;
- trophic ulcer;
- dermatitis and eczema;
- the thrombosis of the veins of the lower limbs;
- infectious diseases.
Against-indication to the operation is pregnancy and period of breastfeeding of a child, a high degree of obesity, age above 75 years. It is not possible to operate lying sick or with reduced mobility.
Types of intervention
The modern clinical practice of surgical treatment of the varicose veins is performed in various ways. The task of the surgeon to exclude from circulation in the affected vessels, which is achieved through deleting them using special hardware of microsurgery. The contemporary operation when varicose veins is the minimum intervention with good effect.
Sclerotherapy applies to non-invasive techniques for the treatment of varicose veins. If it is made in the early stages of the disease, the result will be a complete cure. In the later stages of his match with other types of intervention.
As a technique of sclerotherapy using branched into small vessels at the surface. When the operation in the large veins clean up small branches, the area of the vein to the final step. Types of sclerotherapy:
- Echo sclerotherapy applies, in a greater degree, as a beauty treatment. Your goal is to resolve expressed in the vascular mesh and small speakers in vienna. The essence of the technique consists in introducing into the vein a special composition that has been plaguing the glue and wall. Introduction sclerosant is performed under the control of the ultra-sound. The treatment involves several procedures, the visible effect, arrives in 2 months. In some cases, it is used for the treatment of deep and large veins.
- Micro hardening applies in small vascular gear.
- Micro foamy sclerotherapy — innovative method, where as sclerosant use a mixture of drugs and air.
- Traditional, hardening of the veins, large areas via a catheter.
After the procedure leaves no marks on the skin, which is its full dignity. Disadvantages include the possibility of relapse of the disease, as well as the clearance of vienna, you can not completely close.
Laser coagulation of vessels — more a minimally invasive way of treating varicose veins. Its advantage consists in the possibility of performing the operation, even if you have trophic ulcers. There are two ways of laser coagulation — percutaneous and Dr. Percutaneous eliminate varicose veins. Such a method is only use in their vessels with not more than 3 mm in diameter. The laser beam, ignoring the general characteristics, heats up the capillaries up to 70°With. They are converging, the circulation through it stops. Constraint on the realization of the coaxial intravascular laser coagulation serves a diameter of vienna — that should be not more than 1 cm. The procedure is done in the following way:
- The doctor done the duplex scan patient of vienna and is a marker of its contours in the skin.
- The location of introduction of the tip of the guide, disinfected.
- In the vein is introduced into a light guide, the laser operates simultaneously in the blood and in the vessel wall. The blood evaporated and the protein shell to the inner vessel are improving, pasting it to a. The remaining endothelial cells, subsequently, form the connective tissue in the local "sealed" in vienna.
The whole operation takes no more than 45 minutes. As an echo sclerotherapy, which is done under the supervision of the ultra-sound. The rehabilitation period (up to the complete disappearance of traces and advanced vessels), it takes a month and a half. The first five days, you have to use a mesh of compression and follow all recommendations of your doctor.
With the-wire intravascular electrocautery, obtains the same effect as when exposed to the laser. For coagulation and obliteration of the vessel are used electrodes connected to a generator of high frequency current. The technique exists since the middle of last century, is considered obsolete and is rarely used in modern clinical practice.
Removal extended vein using low temperatures, it is hardly practiced in our country. For cryosurgery, requires expensive equipment and highly qualified professionals. Only thus can ensure the total safety of the operation. The operating principle similar to a laser coagulation of the vessel is inferred from the system of blood circulation through obliteration.
Sometimes, it is not possible to limit the removal of only the trunk of the vein, in order to eliminate the reset. For this, it is necessary to prevent blood flow through veins that connect the surface vessels deep. Such operations when varicose veins are necessary when persistent trophic changes. The procedure is an endoscopic intervention, for which it is required only a small incision in the upper part of the tibia. The intersection of the vessel is running ultra-shear. Today endoscopic procedure, the procedure is also somewhat popular, such as electrocoagulation. Your gradually replacing modern non-invasive techniques.
Comtripping — you have the option of operation when the varicose expansion of the veins. Removal of the patient from vienna, in its entirety or only the affected area is done through small incisions through a special device — a special probe. The incisions are made just below the groin and above popliteal fossa or above the ankle and popliteal fovea. Vienna onDrasaeda with the two ends and tied, and the affected area removed. The surgery is performed under local anesthesia and takes about an hour and a half. It allows you to remove the vessel ill, regardless of their length and diameter. The modern phlebology use a special type of operation, stretching of the vein through a puncture.
Radiofrequency ablation of the vein
The method of radio frequency ablation doctors borrowed cardio practice surgical. This is the obliteration of the vessel under the action of high-frequency voltage which produces temperatures up to 120°. Not to damage the surrounding tissues, around the special vessel to numb the remedy is formed "water comforters". An impulse gives you the opportunity to deal with 7 cm of vienna. The device is equipped with automatic temperature control in the vessel and control the flow of energy.
Operations during the execution of the varicose veins
The operation is expected to wear the veins in the region of the tibia. Implemented it through a small fine-cut with the endoscopic instrument. Indications for intervention in later stages of varicose veins:
- wide defeat of the veins;
- valve kidney failure;
- the involvement in the pathological process perforating veins.
The operation of Muller, or mini-phlebectomy, applies to thrombosis and strong varicose expansion of veins. Through small incisions are drawn from the patients of vienna. Incisions not stitched with a, and you shrink a band-aid, so after the surgery, the skin there is no residue. The operation Muller is considered one of the best methods of surgical treatment of varicose veins, as well as after it there is almost no recurrence of the disease.
One of the most effective and sought after operations on removal of varicose veins feet — combined phlebectomy. Steps to take at different stages of the disease are used as independent methods of treatment:
- another is to dress the big and small hypodermic veins in their places to fall in a deep vein;
- Peel it off, when they remove the affected part of thrombosis venous trunk;
- the crossing (ligation) to pierce a vein for the termination of horizontal venous thrombosis relief;
- mini-phlebectomy — removal of us and extended the vein through small holes.
Preparation for the operation
Before the operation, necessarily, the examination is being conducted. The goal of the diagnosis to determine the general state of the patient. For this, laboratory. Set the degree of varicose veins and the location of the plot, that you want to delete, help ultrasonic Doppler scanning. In some cases, it is assigned to a computer or magneto-resonance imaging.
Minimally invasive intervention carried out without special training. If you plan to operation combined, on the eve of the patient recommend eating a light dinner (no more than 6 hours in the afternoon), and to do a cleansing enema. The selection of compression of knitted fabrics is produced in advance. The operation when varicose veins of the lower limbs is performed in the fasting, with the pre-ultrasonic research of vienna, the material to be removed.
How to make the operation of the varizesy expansion of the veins
The operation to get rid of varicose veins feet should eliminate the reflux (return flow of venous blood). Using in each phase of modern techniques, even combined phlebectomy pass today in the hospital a day, or the patient sent home the next day after the surgery. In this case, general anesthesia is required. If carried out an extensive intervention, the patient give general anesthesia or do spinal anesthesia (anesthetized only the lower part of the body). The time of stay in the hospital 1-2 weeks.
In the first phase, from the bloodstream is shown to the subcutaneous vienna through your bandage or crossing at the junction with the deep vein. Depending on the location of the affected area, the incision is made in the groin or in the popliteal fovea.
After crossing the fabric of vienna it removed. Are, generally, limited thighs phase (short to Peel), because most of the times suffer by it. Removal of the probe is considered as the most reliable way. For this reason, in the area of the ankle or of the upper part of the leg is made even a scrap. The probe with the cutting tool at the end is started through one of the holes and is pulled through the second. The end of vienna assigns to this instrument, and it is extracted to the outside. More protects the technique PIN-Stripping. The end of sick of vienna, is fixed on the filament to the wall of the vessel, and the surgeon removes it, twist from the inside to the outside.
The next step is the ligation of perforating veins. Just a little bit, and he has access to, so the muscle fascia is not cut. This avoids visible cosmetics. If you defeat multiple, the doctor is obliged to dissection of the muscle, which gives a more durable result. Application endoscopic procedure allows to make an operation less traumatic, but does not work in all hospitals, so as to be sophisticated expensive equipment.
Ends the operation of the combined mini-phlebectomy, you can remove visible deformations of the vessels. By following the marks on the skin, the surgeon through small holes remove small vienna. Ends the operation of suturing and elastic bandage.