A procedure in which leg varicose veins causing symptoms or carrying a risk of complications are removed by classical surgery (stripping) or closed by endovenous laser/radiofrequency methods.
Indication
- Advanced varicose veins causing symptoms such as pain, heaviness, night cramps and leg fatigue
- Cases unresponsive to conservative treatment (compression stockings, weight loss, exercise)
- Skin changes due to chronic venous insufficiency (brown discoloration, eczema, lipodermatosclerosis)
- Recurrent superficial thrombophlebitis associated with varicose veins
- Leg ulcer formation or non-healing wound caused by varicose veins
- Past or recurrent bleeding from varicose veins
- Great saphenous vein insufficiency demonstrated by color Doppler ultrasound
Preparation
- Mapping of the veins with color Doppler ultrasound
- Pre-operative blood tests, ECG and chest X-ray when needed
- Blood-thinning medications (warfarin, clopidogrel) are adjusted on the physician's advice
- No food or drink for 6-8 hours before the procedure (depending on the type of anesthesia)
- Compression stockings to be used after surgery should be obtained beforehand
How it's performed
- General, spinal or local anesthesia is administered according to the planned method
- Vein segments identified by Doppler ultrasound are marked on the skin
- In classical surgery, the insufficient saphenous vein is removed through small incisions in the groin and below the knee
- In the endovenous method, a thin catheter is inserted into the vein and laser or radiofrequency energy closes the vein from inside
- Side branches are cleared with mini incisions or foam sclerotherapy
- Incisions are closed with cosmetic sutures and the leg is wrapped with an elastic bandage
Post-procedure
- Discharge on the same day or after a one-night stay following the procedure
- Regular use of compression stockings for 2-6 weeks (per physician's recommendation)
- Elevation of the leg on the first day, regular walking; avoidance of long periods of standing and hot environments
- Dressing changes and suture removal between days 7-14
- Doppler ultrasound assessment of results at 1-month and 3-month follow-up visits
Risks
- Bruising and induration under the skin (common; resolves within a few weeks)
- Temporary pain, tightness and numbness at the procedure site
- Limited area of altered sensation due to superficial nerve injury
- Wound infection (rare; controlled with antibiotic treatment)
- Deep vein thrombosis and pulmonary embolism (very rare; reduced by early mobilization)
- Skin burns (very rare in endovenous methods, minimized by protective measures)
- Long-term recurrence of varicose veins in other vessels
FAQ
Is laser or classical surgery better?
Both methods are effective; the choice is made according to the structure and diameter of the varicose veins and accompanying conditions. Endovenous methods generally provide less pain and faster recovery, while classical surgery may still be appropriate in some complex cases.
When can I return to work?
Return to desk-based work is generally possible within 2-5 days. For heavy work, prolonged standing or intense sports activity, waiting 2-4 weeks is recommended.
Can varicose veins recur after surgery?
Recurrence in treated vessels is significantly reduced; however, since the predisposition continues, new varicose veins may develop in other vessels over the years. Regular use of compression stockings, weight control and movement reduce this risk.
Is varicose vein surgery performed during pregnancy?
Generally no. A significant portion of varicose veins during pregnancy regress after delivery. If treatment is needed, re-evaluation with Doppler ultrasound is performed at least 3-6 months after delivery.
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