In order to be able to suggest the most effective and safe surgical treatment approach for your venous disease, you will have to undergo a series of diagnostic tests and procedures, which will reveal the specifics of your condition. There are two main tests used to assess venous diseases at the California Heart & Lung Surgery Center:
After your condition is thoroughly evaluated, Dr. Marmureanu will recommend the most appropriate treatment procedure and the date of your surgery will be set. The following four types of surgery are the most frequently employed for removing damaged veins:
This innovative treatment procedure is minimally invasive and, unlike the traditional approach, entails the visualization of the damaged veins due to its advanced illumination feature. The TriVex System is provided with a xenon light source, which allows the surgeon to clearly see the portions of vein that need to be removed. It can be performed under general, local or regional anesthesia, depending on the specific condition you are suffering from and your personal preference. The duration of this surgery is generally very short (less than an hour).
After you receive anesthesia, an endoscopic transilluminator is introduced under your skin through a small incision. A second incision is made near the affected region of your leg, through which a resector (a suction device equipped with guarded blades) is inserted. The problematic segments of the vein are subsequently removed. An additional dose of anesthetic is injected at the end of the procedure to reduce bruising and minimize the risk of blood clots developing. Finally, the incisions are closed with stitches and sterile dressings are applied over them.
Stab phlebectomy, also known as ambulatory phlebectomy, is generally recommended for the removal of large varicose veins, which cannot be treated by less invasive approaches such as scleroterapy. It is also a minimally invasive procedure with a significantly reduced risk of complications and a short recovery period. The intervention is usually performed under local or regional anesthesia. After the anesthetic takes effect, several small incisions will be made in your leg by surgeon Alexander Marmureanu above the affected portions of the vein, which are then removed via the same route. When all the damaged segments have been eliminated, your incisions are closed and sterile dressings are applied over the wounds.
Patients who experience severe symptoms such as intense pain, blood clots and skin sores are generally eligible for this type of surgery. Nevertheless, it can also be opted for when one would like to improve the appearance of their legs. You will first be put under general or local anesthesia by the team at the California Heart & Lung Surgery Center, depending on your overall health and the particularities of your condition. Two small incisions are then made in your leg: one above the damaged vein (typically in your groin region) and one below it (in your calf or ankle). A thin, flexible tube is subsequently inserted in the first incision, with the aid of which the vein will be taken out of your leg through the cut below. Finally, the incisions are closed with stitches and covered with sterile bandages. You will also have to wear compression stockings on your legs following surgery.
Endoscopic vein surgery is only recommended for the treatment of severe venous diseases accompanied by serious symptoms such as leg ulcers. Due to its minimally invasive nature, it is often performed as an outpatient procedure. Local anesthesia is most commonly used for this surgery. However, you can opt for general anesthesia as well if your overall health allows it. During this intervention, several small incisions will be made in your leg. An endoscope (a thin, flexible tube with a fiber optic camera attached) is then inserted through one of the incisions, which will permanently provide us with detailed imagines of the inside of your leg. The affected vein is subsequently removed through another cut. After the completion of endoscopic vein surgery, your incisions are closed with stitches and sterile dressings will be placed over them.
People who regularly experience distressing symptoms due to their venous disease, as well as those who would like to improve the appearance of the affected area, can opt for one of the surgical approaches described above.
Nevertheless, some procedures are not recommended for certain cases of venous disease and you must always discuss with a medical professional, who can guide you towards the most appropriate and low-risk treatment option for your condition.
The most common venous diseases, which can be treated efficiently by surgery include:
The recovery process primarily depends on the surgical intervention you underwent. Thus, while transilluminated powered phlebectomy, stab phlebectomy and endoscopic vein surgery are generally outpatient procedures, which only require you to spend several hours in the hospital, you will have to be hospitalized for multiple days if you had varicose vein stripping. Complete recovery is achieved in one to two weeks for minimally invasive procedures, while more complex surgeries entail a longer recovery period of approximately one month.
Regardless of the treatment you received, you will be prescribed pain relievers and antibiotics after surgery to alleviate your discomfort or pain and prevent infections. Your vital signs will be carefully monitored for several hours or days after the effect of the anesthetic wears off and you will be advised to keep your leg elevated when you are sitting to avoid the forming of blood clots, as well as to wear compression stockings for a while.