Varicose veins on the surgical treatment of the legs

For many decades, the surgical treatment of varicose veins of the legs remains the only radical method to eliminate this disease and its complications.Thanks to modern technologies and the improvement of operational techniques, it is truly effective both in therapeutic and cosmetic terms, it is carried out as easily and painless as possible, well tolerated by patients and does not cause prolonged disability.

Normally, about 30% of the blood from the lower ends flows through small subcutaneous venous tributaries, which merge into two central venous trunks: a large and small subcutaneous vein.These vases are directly connected to the deep veins, through which 70% of the blood flows.In the places of these compounds there are valves that cross the blood only from the deep surface veins.There are also dozens of small veins, which also connect the venous surface network with deep.They also have valves that cross the blood in one direction.The main cause of the varicose veins is the failure of the venous valves, which leads to improper blood discharges: from deep veins to the surface, which increases the pressure in them and leads to the expansion of small vessels and central venous trunks.The main objectives for which surgical treatment is aimed at the varicose veins of the lower ends:

• The elimination of the stagnation of the blood in the altered surface veins of the legs, which will prevent the progression of chronic venous insufficiency and trophic disorders on the skin.
• Removal of deformed vases and varieties that represent a cosmetic defect.
• The elimination of the drainage of the blood from the deep veins in the superficial ones: the binding and the intersection of the perforating veins (clan), as well as a large and small subcutaneous veins in the places of their connection with the deep ones.
• Prevention of a repeated occurrence of varicose veins.

A separate place in the surgical treatment of female varicose veins of the lower limbs belongs to cosmetic surgery.After these interventions, not only pathologically altered veins, but also postoperative scars on the skin of the legs, or they are inconspicuous.To obtain the maximum cosmetic effect, surgical surgery for varicose veins is carried out according to the following methods:

• Laser ablation or radio frequency of the veins burning the central trunks of a large and small subcutaneous vein under ultrasound control through a drilling of the skin on the thigh or on the foot.
• Scleroblitteration of the stem and sclerotherapy - by filling in large and small subcutaneous veins, as well as all their tributaries, even the youngest ones, with a special drug.

With any of the treatment methods described, the varicose veins are not removed, but are transformed by the blood vessels into a soft cicatricial tissue.Both physical influences (laser rays, radio frequency) and chemical compounds (sclerosing) destroy the internal layer of the vein.Thanks to this, it loses the light, glue and completely desolate from the blood, transforming itself into a normal connective tissue (cicatricial).Therefore, without the direct removal of the veins, all the objectives assigned to the rapid treatment of the varicose veins of the lower ends are achieved: the modified vessels are eliminated and the dangerous consequences of venous insufficiency are eliminated in them.The only restriction of cosmetic operations in the treatment of varicose veins in women is possible only the veins slightly or limited to 1-2 degrees.During pregnancy and in the first postpartum period, the surgical treatment is contraindicated with the exception of acute situations that require an emergency intervention, for example, with ascending thrombophlebitis.The operation is limited to the dressing of a large subcutaneous vein in the place of its connection with the femoral (Crocectomy).Consider the most common surgical interventions in the treatment of varicose veins of the lower ends: laser ablation, endoscopic dissection of the veins and phlebectomy.The latter is divided into the following types:

• Classic operation or complete stripping or operation of Trojanov-Trendelenburg-Bubko-Narata;
• short stripping;
• Flobectomy.

Flobectomy

Removal, the extraction of veins from under the skin is called phlebectomy.This is one of the first methods of surgical treatment of varicose veins of the lower ends.But even today, phlebectomy is often performed by phlegology and vascular surgeons.There are three changes and operating methods: short stripping, miniflectomy.Domestic surgeons call the classic Flebectomy the Trojanov-Tresndelenburg-Bubko-Narat operation and foreign authors with complete stripping.The volume of intervention is presented:

1. Like a trunk bandage of a large subcutaneous vein in the place of its confluence, 2-3 cm on the thigh under the inguinal fold, in the thigh, through an incision.
2. Its removal through the inguine to the foot using a special probe through two skin cuts 1-2 cm along the internal surface near the knee and ankle.
3. The removal of all varicose veins and small veins through small separate engravings is about 1-2 cm (they can be from 5-6 to 10-20) with the dressing of insolvent perforative vessels.
4. Sew all wounds with cosmetic seams.

Classical phlegmctomy allows you to remove varicose veins, but the most traumatic of all existing techniques.

Short stripping

With a short stripping, the entire large subcutaneous vein is not removed, but only its fragments, influenced by varicose veins, for example, only on the thigh or on the lower part of the leg.Healthy segments are not removed.This reduces the trauma of the intervention, but remains the risk of recurrence of the disease.Otherwise, the operational operations of the operation are similar to classical phlebectomy.

Flobectomy

The innovative methodology for the removal of small varicose veins of a large subcutaneous vein is called phlebectomy.For its implementation, special tools are needed (pointed scalpels, hooks, terminals, spatula), with which the veins are extracted through the skin of the skin several millimeters.It is not necessary to sew these leather defects, the scars are invisible.Very often, surgeons combine a short or complete stripping of a large subcutaneous vein with Flectomy.Such a combined operation combines radicalism and adhesive trauma with a good cosmetic effect.The laser ablation for varicose veins involves combustion with a laser beam of a large subcutaneous vein throughout the side of its clearance.To do this, through the drilling of the skin on the thigh or in the ankle area in the lumen of the vein, a catfish-verdist is introduced throughout its length.Under the control of the ultrasound, Svetovod is slowly extracted.The laser beam, which acts on the venous wall, destroys the internal layer.As a result, Vienna falls and ceases to work, which is clearly visible on the ultrasound monitor.If not only the main venous trunk is influenced by the varicose veins, but also by its tributaries, they are removed according to the phlebectomy method.

A disease such as varicose veins is a disease characterized by the dysfunction of vascular walls and the weakness of the valves in the veins, which causes stagnation in the blood vessels of the lower limbs and by the appearance of venous nodes.This pathology is quite dangerous and full not only with trophic disorders and the presence of an inflammatory process, but also for lack of tissue nutrition.As a rule, this contributes to the formation of blood clots, which can spread through blood flow through the whole body and the appearance of trophic ulcers difficult to live.In addition, the formation of thrombotic formations within the vases threatens the development of a disease such as thrombophlebitis.Therefore, if the patient has varicose veins of the lower limbs, surgical treatment is mandatory, especially if the disorder is launched.I would like to attract the attention of the readers of our site that surgery for varicose veins of the lower ends is a radical measure and, as a rule, it is prescribed if it cannot do without.Varicosa disease of the lower limbs, the surgical treatment involves different, more used in surgical practice options for surgical treatment.These options are directly in the approach to the removal of the ships and the interested veins of the lower ends.

• The use of traditional phlebectomy in surgical practice for the radical treatment of varicose veins.This option is performed in accordance with Babbok's methodology.This implies the introduction of a probe specifically designed for this procedure in the ship's light and the subsequent extract of the vein through a pre -faced engraving on the skin.After the operation, its cable is performed with a cosmetic sewing, then making it almost invisible.
• Flebectomy: this operation is needed to remove small sections of blood vessels and veins, influenced by varicose veins.Note that this operation does not include cuts on the skin, since part of the ship or vein concerned is removed by drilling on the skin, which does not require imposing seams.

Note that surgery in the treatment of some diseases is shown a lot.However, the varicose veins of the lower limbs, surgical treatment is extremely necessary if the removal of blood clots and potentially dangerous sources of the inflammatory process is required.This approach will improve the patient's condition and help avoid serious and insecure for the health and life of the patient's complications.States that require urgent surgery for varicose veins include:

• the presence of thrombophlebitis or the risks that cause its appearance;
• acute thrombophlebitis or frequent exacerbations of the disease;
• Wide defeat of blood vessels and veins;
• The constantly disturbing feeling of fatigue and gravity in the legs, unpleasant pain, which indicates a varicose veins clearly expressed;
• The appearance of trophic ulcers.

There are also some contraindications to the operation for varicose veins:

• second and third trimester of pregnancy;
• the presence of acute infectious disorders;
• exacerbation of the pathologies existing in a patient (diabetes, asthma, peptic ulcer and others);
• myocardial infarction, stroke;
• Dermatological problems.

Strupping - As a rule, this method is used in the presence of a small section of the lesion, this is a technique that is more saved, unlike traditional phlebectomy.The method consists of stretching, through a special hook, the most venous knot.There is also a subspecies of this technique: Cryostropping, which implies the sinking of the damaged ship to the Cryosonda and its subsequent removal.

Sclerosi - The technique involves the introduction of a damaged sclerosing, a special substance for the "gluing" of the ship's walls.However, after the procedure, the vein does not extend, but remains in place, without satisfying its purpose, although the blood flow through Vienna and stop, however, this function is performed by collateral vessels, which does not violate the outflow of venous blood.The operation is performed under the mandatory control of a specialist with ultrasound equipment.

Laser coagulation - This method is the most innovative in the treatment of varicose veins and is the introduction of special equipment with laser radiation (thin probe) in the lumen of the vein.The device has a cauterizing effect on the walls of the blood vessel.

Consequences after surgery to remove varicose veins:

• the aspect of characteristic postoperative hematomas on the surface of the body, which, as a rule, are resolved for several months;
• In addition, after several months, the gaskets under the skin located along the bed of the remote ship disappear;
• Violations of the integrity of the lymphatic system (blood vessels) of the blood vessels, which can lead to stagnant processes.These postoperative consequences are treated conservatively, however, often the circulation of the sap is restored after a few months;
• Possible damage to subcutaneous nerve endings, which manifest themselves from the compromised sensitivity of the epidermis, this postoperative symptoms passes after 5-6 weeks.

Summarize

Varicosa disease surgery

Traditionally, phlebectomy (Crocectomy) is performed according to the Bebcock method and consists in the introduction of the probe in the lumen of the vein with the subsequent stretch of the vein completely for its length by cutting the external skin.The incision is sutured at the end of the operation with a cosmetic seam.Flobectomy is used to remove very short areas of the vein during the operation, the veins are not used.The cuts on the skin are not performed and a piece of vein is removed through a thin drilling on the skin that does not require imposing seams.With a small area of damage to varicose veins, it is possible to perform a more delicate technique: stripping.This is extending with a thin hook only of a varicose node.The experience is carried out by means of two cuts on the skin with their subsequent suture.A variety of this technique is crystropand: "sinking" the vein to the cryosonda using low temperatures, the destructive node is also elongated.

The Sclerosion of Vienna is the introduction of a sclerosing in its light - a substance that "pastes" the walls of the vein between them, but the vein remains in depth under the skin, without performing its functions.The blood flow through the vein stops and crosses the collateral vessels, without violating the outflow of venous blood from the lower limb.Vienna sclerosis is carried out under the control of ultrasound.The laser coagulation of the varicose veins is the last method of phlegology and consists in the introduction of a thin probe in the lumen of the vein with laser radiation, which exerts a cauterizing effect on the walls of the vein.The method of radio frequency exposure of the veins also refers to a more modern treatment of varicose veins, but not all medical institutions are equipped with adequate equipment.The technique consists in the "cauterizing" effect on the vascular wall of high frequency radio waves.