The range of open surgical interventions for the treatment of varicose veins is quite large, but we will not consider open phlebectomy, i.e. removal of varicose veins from incisions.
Unfortunately, this method is still the main one in most hospitals. Its only advantage at the moment is that this technique is provided for by the state standard for the provision of surgical care for varicose veins, and therefore citizens of the Republic of Belarus are performed free of charge in any hospital.
This is where the advantages end, since the technique is much more traumatic in comparison with laser operations and sclerotherapy, requires mandatory hospitalization, spinal anesthesia, postoperative hospital stay from 3 to 10 days, dressings, and, of course, leaves postoperative scars. In addition, its effectiveness and results are highly dependent on the experience and skills of a specialist.
Then what kind of open operations are we talking about?
In some cases, it is possible to successfully use some elements of typical open interventions or their modifications on an outpatient basis without a significant increase in surgical trauma.
So, in our Center, crossectomy is performed, i.e. ligation of the large or small saphenous vein in the area of the mouth and the incompetent valve. With this operation:
- The pathological discharge of venous blood is eliminated.
- As a result, the pressure in the dilated veins decreases and they shrink. In some situations, this approach is more justified even in comparison with laser operations with certain anatomical features in the orifice.
- Crossectomy incisions hide well in the natural folds of the body (groin, popliteal) and after a few months they are no longer visible.
In addition, in such a volume, the operation is performed under local anesthesia, does not require a hospital stay and allows you to return to your usual life and activities the very next day.
Another option for open surgery is miniflebectomy - a modified technique for removing dilated saphenous veins under local anesthesia from small skin punctures 2-3 mm in size.
In this case, special instruments are used in the form of hooks of different sizes and a special technique for isolating dilated veins by hydropreparation with the introduction of a local anesthetic. As a result, relatively large veins can be removed through small punctures. Again, this surgery does not require hospitalization and makes it easy to return to daily life.
There are almost no cosmetic skin defects after vein removal by miniflebectomy. The same technique, along with sclerotherapy, is effectively used to eliminate "uncomfortable" wide veins in the hand.