As the name suggests, open varicose vein surgery is a classical surgery, that is, an incision. In these surgeries, which have been performed for years, patients can generally be administered 3 different anesthesia methods. The type of surgery to be applied determines the anesthesia method.
As always, the patient with varicose veins is referred to Doppler ultrasound after a good examination. In Doppler ultrasound, large and small superficial veins, deep veins and the vein system that provides circulation between them are evaluated. If the amount of reflux in the superficial vein system has increased and the vessel diameter has enlarged, surgery can be decided.
Open surgery techniques;
It can be displaced by ligating the large or small vein. Removal (Striping Method):
In these surgeries, if the leaking vein is the great vein (Vena saphenous magna), it is opened from the groin and its side branches are tied. Afterwards, it is found at knee level and then the vein is pulled and removed with the help of a wire called a striper. If the leaking vein is the small vein (Vena saphenous parva), the kneecap is opened behind it and the side branches are tied. In addition, with the incision made about 5 cm above the Achilles tendon, the lower end of the vessel is found and tied and cut. Again, with the help of a striper, the vein is completely removed. Often spinal (waist numbing) or general anesthesia can be applied. After the procedure, the patient's leg is wrapped with an elastic bandage and is usually kept in the hospital for 1 night. He is discharged the next day after the controls. The suture in the groin is usually aesthetic or non-removable, known as "absorbable". In other regions, the sutures may dissolve or need to be removed, depending on the physician's preference and the patient. In general, the stitches can be removed 1 week after the procedure. The patient can take a bath after the 3rd day. After 7-10 days of rest, she can return to her normal life.
Leaving the large or small vein in place by tying it (Ligation+Division Method):
In these surgeries, the person who has leaked If the superficial vein is the great vein (Vena saphenous magna), it is opened from the groin, if the small vein (Vena saphenous parva) is opened from behind the kneecap, the lateral branches are tied. Then the vein itself begins It is ligated and cut (division). However, the vein is not removed. Spinal or general anesthesia can be applied in this procedure. After the procedure, the patient's leg is wrapped in an elastic bandage and is usually kept in the hospital for 1 night. He is discharged the next day. In other regions, the sutures may dissolve or need to be removed, depending on the physician's preference and the patient. In general, the stitches can be removed 1 week after the procedure. The patient can take a bath after the 3rd day. After 7-10 days of rest, he can return to his normal life.
Removing only visible veins (Pake Extirpation):
This procedure is usually; It is performed to remove puffy and prominent veins from the skin in people who do not have a leak in the large and small superficial vein system or who have had surgery from these veins before. Local anesthesia is mostly used. Before the procedure, while the patient is standing, these varicose veins, known as “pack”, are marked. Then, small incisions are made on them, the veins are cut off and removed and the remaining parts are tied. The patient can be discharged on the same day. After 1 week, the patient's sutures are removed. The veins that connect the deep veins are called perforating veins. They are called “perforan”, which means “piercing”, because they penetrate deep into the muscle layers. In perforating veins, the flow is normally unidirectional from the surface to the deep, and each perforating vein has several valves that allow this unidirectional flow. If these caps fail due to various reasons, the current returns to the reverse, that is, from the deep to the surface. As a result, perforating vein failure occurs. After a certain period of time, this insufficiency expands the superficial veins in that area and varicose veins occur. In recent years, laser and radiofrequency treatments can be applied to perforating veins. However, the course of perforating veins differs from that of other veins. restricts them. In open surgery of perforating veins, the veins are ligated and cut by opening over the perforating veins that were previously marked with Doppler ultrasound. After the procedure, the leg is wrapped with an elastic bandage, as in every varicose vein surgery. After 24 hours, the bandage is opened and the compression stockings are put on. The post-treatment process is the same as the varicose surgeries described above.
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