Skip to main content
Top
Published in: Indian Journal of Surgery 1/2023

18-09-2021 | Varicosis | Original Article

Surgery for Varicose Veins

Author: D. N. Sharmila

Published in: Indian Journal of Surgery | Special Issue 1/2023

Login to get access

Abstract

Numerous surgical techniques are available to treat patients presenting with varicose veins. A balance is sought between advantages and disadvantages of the available techniques to render them suitable for the treatment of varicose veins depending on the patient’s clinical profile. The abolition of axial venous reflux to reduce ambulatory venous hypertension is the critical factor for successful treatment of varicose veins. Surgical ablation in the form of high ligation of sapheno-femoral junction and stripping of great saphenous vein is more than a century old surgical procedure that is still considered the gold standard in surgery. Various surgical techniques have evolved including elaborate open methods with extensive groin and thigh incisions, sub-fascial ligation of perforators using leg long incisions, endoscopic approach, and the recently developed techniques. The modern surgical approaches are minimally invasive, cosmetically appealing, use local anesthesia, and are performed under the guidance of ultrasonography. These surgeries can often be done as office procedures and demonstrate long-term results and similar hemodynamics in comparison to that of traditional open surgical methods. Although endovenous ablative therapies are preferred by both patients and physicians due to potential advantages such as less pain, short duration of hospital stay, faster recovery, technical ease, and short procedure time, the open surgical techniques still have an essential role and definitive indications in the modern clinical settings.
Literature
3.
go back to reference Aburhama B, Cambria C, Comerota D, Eidt F, Farber F, Forbes F, Geary Gloviczki G, Huber K, Mills M, Schermerhorn S, Sternbergh T, Upchurch W edited by Cronenwett JL and Johnston KW 2014, RUTHERFORD'S VASCULAR SURGERY, 8th edition, Elsevier Saunders Aburhama B, Cambria C, Comerota D, Eidt F, Farber F, Forbes F, Geary Gloviczki G, Huber K, Mills M, Schermerhorn S, Sternbergh T, Upchurch W edited by Cronenwett JL and Johnston KW 2014, RUTHERFORD'S VASCULAR SURGERY, 8th edition, Elsevier Saunders
7.
go back to reference Bellmunt-Montoya S, Escribano JM, Dilme J, Martinez-Zapata MJ (2015) CHIVA method for the treatment of chronic venous insufficiency. Cochrane Database Syst Rev 6:CD009648. https://doi.org/10.1002/14651858.CD009648.pub3 Bellmunt-Montoya S, Escribano JM, Dilme J, Martinez-Zapata MJ (2015) CHIVA method for the treatment of chronic venous insufficiency. Cochrane Database Syst Rev 6:CD009648. https://​doi.​org/​10.​1002/​14651858.​CD009648.​pub3
14.
go back to reference Neglen P, Einarsson E, Eklöf B (1993) The functional long-term value of different types of treatment for saphenous vein incompetence. J CardiovascSurg 34:295–301 Neglen P, Einarsson E, Eklöf B (1993) The functional long-term value of different types of treatment for saphenous vein incompetence. J CardiovascSurg 34:295–301
19.
go back to reference Rautio T, Ohinmaa A, Perälä J, Ohtonen P, Heikkinen T, Wiik H, Karjalainen P, Haukipuro K, Juvonen T (2002) Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. J Vasc Surg 35:958–965. https://doi.org/10.1067/mva.2002.123096CrossRefPubMed Rautio T, Ohinmaa A, Perälä J, Ohtonen P, Heikkinen T, Wiik H, Karjalainen P, Haukipuro K, Juvonen T (2002) Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. J Vasc Surg 35:958–965. https://​doi.​org/​10.​1067/​mva.​2002.​123096CrossRefPubMed
21.
go back to reference Perrin M, Eklöf B (2011) Randomized controlled trials in the treatment of varicose veins (2). Phlebolymphology 18:196–207 Perrin M, Eklöf B (2011) Randomized controlled trials in the treatment of varicose veins (2). Phlebolymphology 18:196–207
22.
go back to reference Rasmussen L, Lawaetz M, Serup J, Bjoern L, Vennits B, Blemings A, Eklof B (2013) Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous LymphatDisord 1:349–356. https://doi.org/10.1016/j.jvsv.2013.04.008CrossRef Rasmussen L, Lawaetz M, Serup J, Bjoern L, Vennits B, Blemings A, Eklof B (2013) Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous LymphatDisord 1:349–356. https://​doi.​org/​10.​1016/​j.​jvsv.​2013.​04.​008CrossRef
27.
go back to reference Gloviczki P, Comerota AJ, Dalsing MC et al (2011) The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 53(5 Suppl):2S-48SCrossRefPubMed Gloviczki P, Comerota AJ, Dalsing MC et al (2011) The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 53(5 Suppl):2S-48SCrossRefPubMed
28.
go back to reference Dwerryhouse S, Davies B, Harradine K et al (1999) Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five – year results of a randomized trial. J Vasc Surg 29:589–592CrossRefPubMed Dwerryhouse S, Davies B, Harradine K et al (1999) Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five – year results of a randomized trial. J Vasc Surg 29:589–592CrossRefPubMed
29.
go back to reference Michaels JA, Campbell WB, Brazier JE et al (2006) Randomized clinical trial, observational study and assessment of cost effectiveness of the treatment of varicose veins (REACTIV trial). Health Technol Assess 10:1-196.iii-ivCrossRefPubMed Michaels JA, Campbell WB, Brazier JE et al (2006) Randomized clinical trial, observational study and assessment of cost effectiveness of the treatment of varicose veins (REACTIV trial). Health Technol Assess 10:1-196.iii-ivCrossRefPubMed
31.
go back to reference de Roos KP, Nieman FH, Neumann HA (2003) Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial. Dermatol Surg 29:221–226PubMed de Roos KP, Nieman FH, Neumann HA (2003) Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial. Dermatol Surg 29:221–226PubMed
32.
go back to reference Carradice D, Mekako AI, Hatfield J et al (2009) Randomized clinical trial of concomitant or sequential phlebectomy after endovenous laser therapy for varicose veins. Br J Surg 96:369–375CrossRefPubMed Carradice D, Mekako AI, Hatfield J et al (2009) Randomized clinical trial of concomitant or sequential phlebectomy after endovenous laser therapy for varicose veins. Br J Surg 96:369–375CrossRefPubMed
Metadata
Title
Surgery for Varicose Veins
Author
D. N. Sharmila
Publication date
18-09-2021
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue Special Issue 1/2023
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-021-03044-1

Other articles of this Special Issue 1/2023

Indian Journal of Surgery 1/2023 Go to the issue
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare