Varicose has plagued humankind for centuries, but phlebectomy, as a type of surgery that appeared relatively recently - at the end of the 19th century. To provoke thrombophlebitis can be anything - the wrong clothes, the lack of fiber in the diet, hereditary factors. Half the world's population affected by chronic venous disease, so the problem is very urgent.
Modern phlebectomy techniques
We will not trace all the stages of development phlebectomy - we will focus our attention only on modern technologies used by the doctors. Competent diagnosis allows to choose the optimal method of intervention in individual cases is combined phlebectomy.
The first step is duplex ultrasound scanning, followed by a markup of the affected venous areas. Be administered if necessary phlebography. Depending on the condition of the patient and extent of injury veins doctor choose methods of operation.
- Stripping. This gentle activity allows you to keep a vein to remove only the damaged area. The surgeon makes a puncture in the skin through which the diseased tissue is displayed.
- Laser phlebectomy. Surgical instruments for this type of intervention is generally not needed inside of the vessel is laser photocoagulation. Local anesthesia, then made a puncture and into the vessel is introduced laser light conductor. The burn of the venous wall leads subsequently to its overgrowing. The minimum diameter of the puncture hole is sealed with a special tape. The recovery period of the patient is significantly reduced.
- Radio-frequency obliteration. This type of intervention allows the precise impact on the affected areas of veins with a disposable catheter and thermal control, pain is minimized, reconstruction of veins is done by the surgeon in one setting. And accelerated postoperative recovery period.
Indications and contraindications
Phlebectomy is assigned to is not always. If conservative treatment allows to achieve the desired effect, the doctors will resort to surgery. It is important to remember that the thromboembolism can provoke various diseases (hypertension, heart attack, stroke, diabetes). The lack of medical supervision can lead to disastrous consequences (including gangrene).
Phlebectomy shown in several cases:
- exposed saphenous vein with a pronounced swelling;
- blood stagnation in the lower limbs (standing position);
- varicosedefeat, seized the legs up to the knee (sometimes above);
- the constant swelling and foot fatigue;
- regular pain in the legs;
- the emergence of trophic ulcers;
- the subcutaneous venous thrombosis (above the first);
- burning sensation, flashing along the venous trunks.
When the operation is not carried out
There are situations in which to do the operation on the veins is strictly prohibited. Interference contrary to the contraindications, can seriously complicate the life of the patient. Famous deaths.
Phlebectomy is prohibited in the following situations:
We are not going to discuss in detail all the techniques phlebectomy. Note among the standard points skin incision (made in the distal and proximal regions of the limb where the projected varicose).
Through the incisions, remove the damaged vein trunk. The final stage of the operation is the suturing the cuts. In very advanced cases required combined phlebectomy.
The phases of the combined surgical intervention
If it came down to emergency surgery, doctors can be assigned to combined phlebectomy. This operation consists of Stripping, crossectomy, microphlebectomy and crossing communicative veins. All of these procedures are performed in strict sequence.
Will tell you more about them:
- Crossectomy. At this stage you want to stop the blood flow. For this surface are tied off and cut short. It occurs in the femoral inguinal fold, sometimes in the popliteal region.
- Stripping. Duplex scanning identifies the affected areas of veins, after which the stems are removed. Mostly affects large longitudinal veins, lower leg most often pathological process is not affected. The most common phenomenon - short Stripping (Vienna is displayed through a puncture in the lower leg area and crotch cut). There are several surgical techniques, including Probe Berocca, crosscripting, Stripping and PIN Stripping.
- Suppression of communicative veins. If the communicative veins are localized close to the skin, apply low-impact manipulation. In deep-lying vascular, the doctors activate the endoscopic equipment. The method allows to get rid of unsightly scars and shortens the postoperative recovery period.
- Microphleb. This type of surgery combines beauty with efficiency ratherhigh performance. Under local anesthesia are skin punctures, and then extracted the damaged areas of blood vascular and varices. Vienna is extracted through a special hook. The seams do not overlap, the scars are virtually absent.
Traditional phlebectomy hook.
The rehabilitation period
For each patient rehabilitation after phlebectomy is calculated individually. The recovery period will depend on the General condition of the patient. Matter and chronic diseases, against which flows the varicose veins.
Here are some tips on restoration of the body:
- To turn and bend the leg immediately after surgery. Lift the edge of the hospital bed - it helps to improve blood flow.
- Through the day doctors are allowed to use compression stockings, and elastic bandages. Making the dressing, you can get out of bed.
- The postoperative period also provides preventative massage and exercise therapy. This prevents the formation of blood clots.
- After a week do not overdo it with exercise. Avoid aerobics and gymnastics. Do not take a bath (hot) and do not visit a bath.
- The stitches are removed on the ninth day, take care of yourself in this period of time.
- Twice a month do the compression.
Complications that can happen after surgery
Doctors assess the likelihood of postoperative complications is quite low, but to completely eliminate the risk is impossible. Phlebectomy is a difficult cosmetic procedure, it is surgery. The most unpleasant moments is observed in the first hours after surgery.
List the likely consequences of the actions of the surgeons:
- excessive bleeding;
- reduced sensitivity (manifested in the case of damage to the saphenous nerve);
- suppuration (formed in the hematoma);
- numbness (of the affected area of the lower leg and ankle);
- bruises (a result of laser surgery);
- tenderness (site of impact);
- deep vein thrombosis (rare).
Now phlebectomy is a common procedure, fear which is not necessary. It may be performed in a public hospital or a private clinic. For this you need to contact the Department of vascular surgery. Moscow clinics offer this service for 15-270 thousand rubles (the price depends on the level of the institution, the complexity of the operation and level of training of the surgeon). In St. Petersburg the intervention of the doctor cheaper.