Varicose varicose leg surgery or laser resection? What could be better

18 November 2020

Varicose veins is a disease characterized by a change in the state of the veins of the legs with an impaired blood flow. When the form is ignored, the vessels bulge, resulting in swelling and soreness of the extremities (under load), as well as a cosmetic discomfort. Surgery to remove the damaged veins is effective at this stage.

Indications for surgical varicose veins

Varicose veins can only be done if vasectomy is indicated:

affected most veins;
severe pain and swelling in the legs during exertion, interfering with a normal life;
the formation of open wounds and ulcers is based on the background of the development of the disease. Very dangerous if accompanied by secondary infection;
violation of the permeability of blood through the vessels, often accompanied by convulsions;
marked development of vascular necrosis;
pathological changes in the veins, accompanied by their dilation and convexity. This change is very dangerous due to vascular trauma and also bothersome aesthetics;
blood clots in the veins.

Surgical intervention is only allowed in progressive and unmotivated forms of varicose veins with conservative therapy.

Contraindicated absolute and relative surgical intervention

Varicose leg surgery for varicose veins is not only performed if indicated but also in the absence of contraindications:

Absolutely prohibited	Relative list of bans
Stable high blood pressure	Presence of infectious diseases
Increased blood pressure often	Dermatological conditions affecting the skin of the feet
Chronic heart disease	Inflammatory processes in the body, including blood vessels
After 70 years old	Recovery time from other surgical interventions
Cancer Presence	Chemotherapy
Diabetes and severe asthma	Serious injury to soft tissue
Thin and fragile blood vessels	Acute Renal Renal Disease
Patient with limited leg movement (paralysis) or bedridden	A blood clotting or anemia disorder
End stage varicose veins	Take hormones, antibiotics or other harsh drugs
Complex fractures (with vascular and nerve damage)	Overweight
Allergic reactions to surgical drugs	Patient refused surgery

When holding a child, the condition of the veins of the leg may also be violation. Usually, the pathology goes away on its own after birth. In the case of contraindications, surgical intervention is very dangerous with the patient's condition worsening and even death.

Vein resection

Vein ablation is a surgical procedure to remove damaged veins and restore normal blood flow to deep veins.

Anatomical implications, surgical techniques to remove large veins

The circulatory system of the legs consists of deep and multifaceted veins of the superficial veins, affecting varicose veins. Changes in vascular activity develop due to dysfunction of the valves. During the normal operation of the circuit, the valves are closed, this ensures blood is only circulating in one direction.

In the veins of people with varicose veins, the valves do not close, so the blood may move in both directions, resulting in impaired blood flow, congestion, and veins. protruding circuit.

To restore blood supply to a limb, it is necessary to remove the affected vein (with backflow of blood), that is, a vein amputation. Before the surgery, the patient is undergoing preparation steps (doing tests, scanning the condition of the veins, determining the patient's general condition).

If there are no contraindications, specialists perform surgical intervention, including the following stages:

Access to the affected blood vessel is performed through a small incision (in the groin or incision, depending on the location of the vein). Next, the damaged vein is constricted from the deep vein to block blood flow.
An incision is made near a varicose vein. With the use of a probe, a vessel is separated from muscle tissue, the lymphatic system and small capillaries. Through a tube or using a hook, the damaged vein is removed.
The capillaries are processed to prevent bleeding.
If there are damaged capillaries that form spider veins, they are discarded.
Finally, the aesthetic stitching, disinfectant bandage and elastic bandage are applied.

Surgery is performed under general or local anesthesia. Depends on the size of the vessel and its location.

Effective Level

Vein resection is used at the various stages of varicose development. The procedure is highly effective (over 98%). Restoration of blood circulation takes place in a short time.

Rehabilitation

The effectiveness of the procedure depends not only on the qualifications of the surgeon, but also on adherence to the rules in the postoperative period.

After surgery to remove a vein you need:

stitching care for 7-14 days in the hospital;
wears compression socks or an elastic bandage for 30 days and is done around the clock;
after 30 days, in 3 months, wear specialized daytime underwear
can only perform water procedures with foot wash (surgical site) after removing sutures;
during recovery is prohibited steam bath, hot bath and bath;
Postoperative pain reliever prescribed by a doctor. Elective is forbidden;
additional drugs are taken to prevent blood clots;
use a vascular strengthening drug (vitamins E and C);
must not stand / sit for long periods, wear high heels and tight underwear;
during resting in a supine position, the legs should be higher than the body level. Promotes the flow of excess blood and reduces swelling;
put on timely and gradual physical activity to normalize blood flow (discuss with your doctor);
massage and physical therapy performed with the permission of a specialist;
rejects alcoholic and nicotine drinks. Alcohol stimulates vasodilation, and cigarettes, on the contrary, lead to their narrowing. These effects reduce the efficiency of the activity;
if you are overweight, a low-calorie diet will be indicated.

If the rules are followed, it is possible to fully restore the functionality of the chi after 6 months.

Laser endothelial coagulation

Laser varicose vein resection of the leg is performed when direct vessels of at least 0. 2 cm in diameter are affected and there are a small number of capillaries. This includes the impact of light waves on damaged ships with subsequent welding and destruction.

Device

The laser coagulation of a vein can be done with any of the 3 types of fiber optics:

Fiber type	Action summary
Ending (classic)	This light guide generates beam radiation from the end, ie the vessel is sealed in front of it. The downside is the formation of a hematoma and a feeling of tightness in the veins. The maximum venous diameter is 0. 1 cm.
Radial (with goblin painless radial light guide)	Light waves from the optical fiber form a circle around a diameter. This allows veins of any size to be processed. And also minimizes the risk of hematoma formation and development of puffiness.
Of the 3 radial yarns	Laser with two rings of light is used to eliminate varicose veins. The first circle prepares the vein for the process (removes excess liquid), the second circle welds the walls. For treatment, light guides are created for small and short veins, and for large vessels.

The selection of the device is not only done by the patient but also by the specialist in charge of the condition of the circuit.

What veins can be removed using the EVLK method

Before choosing EVLK by a vein doctor (who examines the veins and excludes varicose veins), the characteristics of the damaged vein are determined. They should be straight and at least 2 mm in diameter.

Therefore, laser therapy can be applied to the following groups of vessels:

small and large saphenous veins;

spherical accessory vein, at least 5 mm from the surface of the epidermis;
The
veins connect the deep veins to the superficial veins.

For other veins, only vein ablation is possible.

Effective

Veins can be removed by EVLK method with 3 types of optical fibers. Depending on the type of device, the effectiveness of treatment varies. When performing a surgery with a end-lamp, the effectiveness of therapy is 94-96%. Operation with radial light guides allows to achieve 100% results in eliminating varicose veins in the legs.

Preparation and Implementation Stages

When choosing to remove varicose veins with EVLK, the patient should undergo the following training:

Cancel hormonal drugs (if taken). Because they can cause the development of blood clots;

one day before the intervention, required to take blood thinning drugs;

screens damaged veins to determine the extent of their damage;

carries out tests to rule out the presence of latent infections or inflammatory processes in the body. Coagulation is also determined;
The
where the procedure is performed should be washed and shaved (no cosmetics are used, only antibacterial soap is allowed).

Before the operation begins, the contours of the vessels are damaged, the laser / fiber insertion site and the location of the branching capillaries are marked. These marks allow you to solder the beginning and end of the vein, as well as the capillary outlets. The process is performed under ultrasonic control.

EVLK is produced in phases:

Insert the tube through a small puncture (where the catheter is numbed to the site) into the marked area. The light guide will move along it.

Inserts the fiber into the catheter and then it reaches the damaged area. It is performed under the control of the ultrasound on the screen.

An anesthetic injection is given to numb the veins and surrounding tissues.

"Active" light guidance passes through the damaged vein, followed by a delay in the capillary branches (to seal output and prevent bleeding).

Remove the laser by treating the puncture site with an antiseptic and applying an elastic bandage (or using a pressure sock).

After completing the procedure, the patient can be discharged from the hospital immediately.

Recovery Features

To restore the function of an injured limb and prevent the development of complications, you need to familiarize yourself with the nuances of post-EVLK rehabilitation.

They are:

after completing the procedure, you should walk the operated leg for one hour;
Ultrasonic control of the treated vein
was performed on day 2-3

for 5 days, it is imperative to wear specialized underwear around the clock (socks should be discussed with the specialist before surgery). Then, within 45-60 days, the clothes must be used during the day;

does a daily foot massage by walking for 60 minutes a day;

avoid overloading your feet (sit or stand for long periods) and go to the sauna or take a hot shower.

If a vein is still required, the procedure is allowed no earlier than 7 days thereafter.

Benefits of each technique

Varicose leg surgery for varicose veins, depending on the type of intervention, has the following advantages:
is required
mastectomy EVLK

The surgical incisions are about 5 mm, so there are almost no scars No pain during work (using local anesthesia). No general anesthesia

Painless as surgery is performed under local anesthesia. For surgical shredding, local anesthesia is used. EVLK is performed under the control of ultrasound. The result is high accuracy and efficiency.

Low cost Hematoma and pain at the surgical site are rare or mild.

Quickly restores skin color (without the stars and purple purple of the epidermis) This requires 1 puncture, so no stitches are needed and no scars

Short recovery time of about 30 days Up to 5 days recovery time

Effective against all types of varicose veins After surgery, the patient is able to leave the clinic within 1 hour.

It is possible to return to normal life after 24 hours.

EVLK can be performed when the integrity of the epidermis is compromised by an ulcer.

Surgical intervention time must not exceed 40 minutes.

EVLK can be done on both feet in one day. For one sector, the second activity is allowed after 7 days.

The risk of infection during this process is minimal, as the incision / puncture is small.

Complications after laser vein surgery and surgery

There is a risk of complications after surgical or laser vein resection. Negative reactions may occur due to the low proficiency of the therapist or due to a violation of rules during rehabilitation. Possible complications of venous resection and endothelial clotting.

Venous removal method Minor procedural complications Major complications

Venous resection
hematoma and mild bleeding;

increases the temperature;

swelling of the limbs due to a temporary interruption of the lymphatic system, as well as if the rehabilitation rules are not followed;

pain, decreased sensitivity in the surgical area;

formation of seals due to small subcutaneous hemorrhage from the capillaries of the eliminated veins;

purulent seams due to improper handling;

nausea after general anesthesia.

develops deep vein thrombosis (therefore, during recovery, a blood thinner must be taken, and follow the diet prescribed by the doctor);

tissue numbness in the surgical area. Perhaps if the nerve endings were damaged during the operation;

deep phlebitis caused by an infection during surgery or a violation of the rules of care.

Endovenous laser coagulation
hematoma when using guide lamp ends;

swelling within 3 days;

a feeling of muscle tension and soreness where a vein is removed, especially with leg movement;

slight increase in temperature;

appearance of seals at the site of the vein removed due to blood flow to the "vagina";

with insufficient welding of damaged vessel walls, it is possible to restore the blood flow in it and the progression of varicose veins. Needing surgery many times;

changes the tone of the epidermis during the "decomposition of the closed vein" phase. Provided the circuit is close to the skin surface.

blood clot formation in deep veins;
The
laser burns into nearby tissues and nerve endings, then disrupts limb function;

develops an inflammatory process when the infection is introduced into the puncture site;

emits and sticks a piece of fiber in the vein that needs surgery. This happens extremely rarely when using low quality equipment.

During both surgeries, an allergic reaction to the anesthetic may develop.

Measures to minimize complications

Surgical removal of varicose leg veins is sometimes accompanied by the development of complications, to prevent their occurrence it is necessary: 

check for an allergic reaction to the drug used;

excludes infectious diseases and inflammatory processes in the body before surgery;

selects well-proven clinics with highly qualified specialists and modern equipment;

obey the rules during the restore. Especially wearing compressed underwear;

observes diet during recovery (discussed by specialist after procedure). The amount of purified water in the diet increases, the food is processed into small pieces, the diet is fortified with vitamins and minerals;

let your feet rest during working hours;

undergoes a post-operative examination to monitor limb recovery dynamics;

to perform massages and to participate in physiotherapy procedures to quickly restore blood flow.

If you find unacceptable deviations during this surgery, you must contact the clinic immediately.

Comparing forecasts

With both methods of removing leg veins, the probability of complete recovery is 95% higher, but cases of contraindications must be eliminated, complying with the rules during rehabilitation and whenchoose a proven clinic. With surgical treatment, blood flow and the external condition of the leg are restored after 3 months, and with laser therapy, a recovery is noted after 30 days.

In advanced forms, the removal of blood vessels is done with surgical intervention. Treatment is determined not only by the patient's wishes, but also by the presence of indications and contraindications to the procedure. The effectiveness of therapy depends on the qualifications of the doctor and the observance of postoperative foot care rules.

mastectomy	EVLK
The surgical incisions are about 5 mm, so there are almost no scars	No pain during work (using local anesthesia). No general anesthesia
Painless as surgery is performed under local anesthesia. For surgical shredding, local anesthesia is used.	EVLK is performed under the control of ultrasound. The result is high accuracy and efficiency.
Low cost	Hematoma and pain at the surgical site are rare or mild.
Quickly restores skin color (without the stars and purple purple of the epidermis)	This requires 1 puncture, so no stitches are needed and no scars
Short recovery time of about 30 days	Up to 5 days recovery time
Effective against all types of varicose veins	After surgery, the patient is able to leave the clinic within 1 hour.
It is possible to return to normal life after 24 hours.
EVLK can be performed when the integrity of the epidermis is compromised by an ulcer.
Surgical intervention time must not exceed 40 minutes.
EVLK can be done on both feet in one day. For one sector, the second activity is allowed after 7 days.

Venous removal method	Minor procedural complications	Major complications
Venous resection	hematoma and mild bleeding; increases the temperature; swelling of the limbs due to a temporary interruption of the lymphatic system, as well as if the rehabilitation rules are not followed; pain, decreased sensitivity in the surgical area; formation of seals due to small subcutaneous hemorrhage from the capillaries of the eliminated veins; purulent seams due to improper handling; nausea after general anesthesia.	develops deep vein thrombosis (therefore, during recovery, a blood thinner must be taken, and follow the diet prescribed by the doctor); tissue numbness in the surgical area. Perhaps if the nerve endings were damaged during the operation; deep phlebitis caused by an infection during surgery or a violation of the rules of care.
Endovenous laser coagulation	hematoma when using guide lamp ends; swelling within 3 days; a feeling of muscle tension and soreness where a vein is removed, especially with leg movement; slight increase in temperature; appearance of seals at the site of the vein removed due to blood flow to the "vagina"; with insufficient welding of damaged vessel walls, it is possible to restore the blood flow in it and the progression of varicose veins. Needing surgery many times; changes the tone of the epidermis during the "decomposition of the closed vein" phase. Provided the circuit is close to the skin surface.	blood clot formation in deep veins; The laser burns into nearby tissues and nerve endings, then disrupts limb function; develops an inflammatory process when the infection is introduced into the puncture site; emits and sticks a piece of fiber in the vein that needs surgery. This happens extremely rarely when using low quality equipment.