Varicose Vein Surgery

Varicose veins refer to enlarged and twisted veins in the leg, a condition that is often genetic and is made worse by excessive standing. How does this happen?

Our legs contain a group of deep veins buried within our muscles and a group of superficial veins that run underneath the skin. When a weakness in the walls of the superficial veins causes enlargement, there is a build-up of pressure that bulges out as varicose veins. Typically, varicose veins appear in the thighs and calves. They may look blue and bulge, and cause plenty of discomforts.

What is the treatment for varicose veins?

Varicose veins need treatment only when they cause discomfort. Treatment is necessary to ease symptoms like pain and to treat complications that may arise such as swelling, leg ulcers, or skin discoloration. Before treatment, physicians may recommend some self-care measures at home such as –

• Compression stockings for putting pressure on the veins
• Avoiding standing for long periods
• Regular exercise
• Elevating the affected area when resting
• Avoiding crossing legs so blood vessels aren’t pinched

There are also less invasive options for treating varicose veins such as include endovenous radiofrequency ablation, sclerotherapy, endovenous laser treatment, and surface laser treatment. One should consult the doctor about all possible treatment options before deciding on varicose vein surgery. 

When is surgery required?

Varicose vein surgery is a general term used for various methods of surgically treating varicose veins.

A varicose vein surgery is done in the following cases –

• Symptoms aren’t relieved with self-care measures
• Complications occur such as leg ulcers
• Veins cause bleeding through the skin
• Inflammation in the veins and overlying skin
• The appearance of varicose veins is upsetting to the individual

Varicose veins can be surgically removed in such cases. Because the damaged valves in the veins cannot be cured, removing them altogether is the only option. The aim of varicose vein surgery is to take pressure off the veins in the leg by tying or removing them. This doesn’t affect the blood supply to the legs; the blood is re-directed by other, healthy veins after the surgery. The result is that existing varicose veins are prevented from enlarging and new ones are prevented from growing.

What does the surgery involve?

Varicose vein surgery is one of the most commonly performed types of surgery. A combination of general and local anaesthesia is administered, depending on the type of surgery performed.

The main procedures used to remove varicose veins are –

• Vein ligation and stripping – In this procedure, the surgeon makes two cuts – one at the top of the leg below the groin and one behind the knee. The vein is first tied off where the top incision is made, a procedure called vein ligation. It is then entirely pulled out through the incision near the groin. For the most serious cases, this surgery is performed. The recovery time can range from 1 to 4 weeks.
• Phlebectomy – In this procedure, which is less complicated than vein ligation and stripping, several tiny cuts are made along the affected vein. Using a small hook, varicose veins close to the surface of the skin are then pulled out of the cuts. This technique is generally used for smaller veins.
• PIN stripping – In this technique, the vein is removed through one incision near the top of the leg. The doctor runs a device called a PIN (perforate invaginate) stripper through the cut and pulls the vein up.

The surgeon can perform one or more of these, depending on the location and types of veins that require treatment. Surgery can also be combined with other less invasive procedures.

A varicose vein surgery is very effective in relieving symptoms like pain, swelling, and itching or it eliminates them completely. After the surgery, new varicose veins develop in a few years.

What happens before the surgery?

Before varicose vein surgery, a number of tests are done on the patient. There are of two types – to assess if the person qualifies for varicose vein surgery and some pre-operative tests like blood tests and ECG.

Can complications happen?

As is the case with all surgeries, the risk of complications exists. Some general complications include bleeding, infection, pain, scarring of the skin, and blood clots in the legs. More specific ones are numbness, nerve damage, developing a lump under the wound, swelling of the legs, etc.

How long does recovery take?

Typically, patients can go home the same day or the day after. Once the wounds are healed, patients can carry out normal activities. It is often advised to exercise regularly to be able to return to one’s usual life as quickly as possible.