Varicose Veins Surgery

Nowadays, surgery is only recommended after a patient has failed to respond to a range of preventive and self care measures. However, surgery may be required in rare cases where the patient is at risk for developing complications, such as leg ulcers, eczema, phlebitis and deep vein thrombosis (DVT).

A physician may also advise surgery if the patient is in constant pain, exhibiting permanent skin alterations such as tightening of the skin, chronic eczema or ulceration.

Last but not least, a common reason for performing surgery is cosmetic improvement.

Vein Stripping and Ligation

Vein stripping surgery is performed less frequently nowadays, due to the increasing availability of less invasive options. Stripping (total removal) and ligation (tying and sealing) are extensive hospital procedures that require local or general anesthesia and a recovery period of up to eight weeks.

Stripping entails making small incisions either behind the knee or the groin and passing a thin flexible device into the vein. Damaged blood vessels are then tied at the source or removed completely.

If large veins are involved, the blood vessel may be removed using a technique called “inverted stripping,” where the whole length of the diseased blood vessel is “inverted” and removed through a small incision in the skin.

In less severe cases, a procedure called “mini-stripping” may be recommended. This technique involves removing only small sections of the damaged blood vessel.

In all cases of stripping and ligation, the aim is to allow the blood to re-route through the patient’s remaining healthy blood vessels.

Possible risks of stripping include:

  • complications associated with general anesthesia
  • post-operative swelling, bruising or bleeding
  • formation of new varicose veins
  • infection
  • slight numbness in the leg
  • localized scarring
  • recurrence in an estimated ten percent of patients.

Radio Frequency and Laser Varicose Vein Treatment

Recent developments are focusing increasingly upon less invasive procedures such as the use of laser treatment and light techniques. These are less disruptive to the patient, require no general anesthesia, leave minimal scarring, and are less painful.

The use of radio frequency devices and lasers is now commonplace. Laser therapy, for example, is often used in cases where previous sclerotherapy treatment has proven unsuccessful. This type of treatment is also useful for patients who are afraid of needles.

Radio Frequency Ablation: VNUS Closure

Radio frequency ablation is a minimally invasive technique that seals damaged blood vessels rather than remove them. The procedure is less painful than stripping; scarring is reduced and recovery is much quicker.

One type of radio frequency ablation, VNUS® Closure®, is performed as an outpatient treatment. In the Closure technique, a tiny catheter is inserted into the vein through a small incision. The blood vessel wall is then heated using radio frequency energy to “close” the damaged vein wall. The Closure method is particularly effective for treating the condition known as superficial venous reflux.

Endovenous Laser Treatment (EVLT)

Endovenous laser varicose vein treatment is an outpatient procedure that involves inserting a small laser fiber through the skin, into the diseased blood vessel. Pulses of laser light are targeted inside the vein, causing it to collapse and seal. EVLT is performed under local anesthesia.

Resources

American Academy of Dermatology. (nd). Spider vein, varicose vein therapy. AAD Brochure.

American College of Phlebology. (nd). Phlebology: The treatment of leg veins. Patient Information Brochure.

Grinsted, P. (updated 2005). Varicose veins.

Lancer Medical Group Ltd. (nd). Varicose veins information.

Mayo Foundation for Medical Education and Research. (2005, January 17). Varicose veins.

National Library of Medicine. (updated 2003). Varicose veins. MedlinePlus Medical Encyclopedia.

Venous Education Institute of North America. (nd). Getting a leg up on varicose vein treatment choices.

VNUS® Medical Technologies, Inc. (nd). The Closure® procedure.

WholeHealthMD, LLC. (2000). Varicose veins.