Varicose veins in the leg occur in the major superficial vein of the leg which is known as the saphenous vein. In some unlucky individuals, the entire saphenous vein becomes varicosed. Despite all the latest treatments available today, large thick and tortuous varicose veins are best removed by stripping of the saphenous vein. Stripping basically means removing the entire vein.
The goals of vein stripping is to relieve pain, swelling and improve the cosmetic appearance of the leg. Vein stripping involves the removal of the saphenous vein and its branches. The surgery is done as an outpatient.
Prior to the procedure, an ultrasound will be done to determine functioning of the vein and the presence of blood clots. The surgery can be done under spinal (needle placed in the back and an anesthetic injected) or general anesthesia.
Once you are asleep, the entire leg is cleaned and then draped with sterile towel. The surgeon will make a 2-3 inch incision in the groin and identify the saphenous vein and its branches. All the branches will be tied off to prevent recurrences. Another 1 inch incision will be made in the ankle and a stripper is passed through it. The vein is then removed with the stripper. Both incisions are washed and closed with sutures. During the procedure, there is some blood loss which is well controlled. After the procedure, an ace bandage is wrapped around the leg. The patient is asked to leave the compression bandage on for a few days to limit the bruising and swelling of the leg.
The side effects of vein stripping are minimal and most are temporary. The side effects include:
- bruising of the leg
- allergic reactions
- side effects related to anesthesia
- pain which is mild to moderate
- numbness along the leg
Complications of surgery:
- Failure to remove the vein
- Incomplete removal of the vein
- Removal of the wrong vein
- Recurrence of varicose veins
All individuals are asked to ambulate the next day and when resting, keep the leg elevated. Showering is permitted the next day but the affected leg must be kept dry. The pain is usually mild and can be controlled with over the counter pain medications. Most individuals are able to resume their normal activities in 7-10 days. The surgery when done to perfection has the least chance of recurrence of varicose veins. The surgery is performed by both general and vascular surgeons.
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