Varicose Veins
Varicose Veins are swollen Veins (usually on the legs) that look lumpy and bluish through the skin. They occur when the valves in the Veins become weak, allowing blood to collect in the leg veins instead of travelling back to the heart. At the London Day Surgery we offer a number of options for removing Varicose Veins and restoring a smoother appearance to your Legs:-
Laser Ablation ELVeS/ELVT
Sclerotherapy
Surgery
Laser Ablation ELVES/ELVT
Laser ablation ('ELVeS','EVLT') is a new non-surgical way of treating varicose veins which has been developed over the past five years at centres in USA, Spain and Germany. It is performed as an outpatient 'walk in, walk out' procedure with no requirement for general anaesthetic or overnight stays in hospital.
The laser treatment involves the insertion of a laser fibre into the varicose veins of the thigh from the knee to the groin using ultrasound imaging to guide the way. The laser fibre is then withdrawn along the vein, heating it from within to close it, using local anaesthetic to minimise discomfort. The treatment session lasts in the region of one hour.
A pressure stocking is applied and must be worn for a week. The majority of patients can return to normal activities including work the next day. Further visits may be required to eliminate secondary varicosities and superficial unsightly veins (spider veins).
Sclerotherapy
Sclerotherapy is a procedure in which a physician or nurse, using a syringe with a tiny needle, injects a small amount of a concentrated saline solution directly into the thread vein.
The solution displaces the blood within the vein, making it blanch or turn white. The solution then causes the vessel to become irritated and to close, preventing the blood from re-entering the vein.
The veins will gradually fade and within two to eight weeks following treatment some will completely disappear. A maximum of 4 treatment sessions will be required to achieve optimum results.
Following each treatment you will be required to wear support tights supplied by the clinic, for approximately 3 days. For the first 48 hours after treatment it is best to avoid strenuous exercise, hot baths or saunas. You should not take travel by air or take any long journeys for up to one month after treatment.
The cost of Sclerotherapy is £200 per treatment, Maximum 4 treatments with 4-12 weeks in between each treatment.
Varicose Vein Surgery
Surgical treatment of Varicose veins may be required to alleviate aching and to stop recurrent bouts of phlebitis. Surgery is especially necessary when the valves at the groin (the sapheno-femoral junction) and/or the back of the knee (the sapheno-popliteal junction) are leaking (incompetent).
There are two main types of surgical procedures used to treat Varicose veins:-
Phlebectomy is used for moderate sized Varicose veins. In this procedure a surgeon makes a series of tiny (2-3mm) puncture holes along the veins and then takes out small segments of the vein with a tiny hook.
The tiny incisions require no stitches and rarely leave any scarring. Most people experience very little pain after the operation and are able to walk immediately.
Phlebectomy can be performed in one or more sessions under local anaesthesia although general anaesthesia is preferred by most patients.
Vein ligation and stripping removes the long and/or short saphenous veins (the main surface veins in the legs).
The surgeon makes two or three small incisions - one in the groin and/or behind the knee and the other near the side of the knee. The saphenous vein and its tributaries can then be tied off and divided from the deep system based on the femoral vein in the groin and the popliteal vein behind the knee.
A flexible wire is then passed through the vein from the groin incision along its entire length and using this wire the vein is stripped out. Veins are not stripped below the knee.
This is usually combined with tiny phlebectomy incisions, as above. A person undergoing this procedure may receive either general anaesthesia (to be asleep for the procedure) or an epidural (a local anaesthetic injection into the back that numbs the lower half of the body) or very local anaesthesia injections into each site where incisions are made. Patients usually prefer general anaesthesia.
Some doctors believe that the long saphenous vein should never be removed because it is the primary source of a vein used for heart bypass operations. However, other surgeons feel that if it is damaged, as it is when it is varicose, it will not be suitable for use in bypass surgery anyway.
Recovery
Most patients are able to leave hospital on the same day as the surgery or, at the most, the day following surgery.
The bandages and any stitches used (usually self-absorbing) will be removed after seven to ten days, during a follow-up visit.
It usually takes two to six weeks to recover completely from the operation. During that time it is advisable to keep the leg or legs bandaged, take several short walks every day, starting with five minutes each time and slowly increasing the time and distance covered and keeping your leg elevated above your hips level when lying down or sitting.
Most people are able to return to work within one to two weeks of the operation.
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