Classic open surgery
27 apr 2015
Classical phlebectomy (removal of varicose veins, venectomy, Backcock phlebectomy, Troyanov’s, Linton’s operation, Narat phlebectomy, etc.) is a surgical procedure that was developed over a hundred years ago and is still used in many public and private medical institutions. institutions. Since this operation takes place under general or spinal anesthesia, there is always a risk of complications, therefore, classical phlebectomy should be performed only in medical institutions where there are intensive care units. The operation is performed as follows: first, an incision is made in the groin or under the knee and a vein (large or small saphenous) is secreted, then a metal probe (string) is inserted into the vein, one end of the vein is attached, and through the other incision on the leg, the varicose vein is “pulled out” . Individual varicose veins are removed, also from individual sections. In general, this operation is not bad and effective, but very traumatic. On the first day after a classical phlebectomy, patients lie down and do not get up for about a day, since this time anesthesia still exists and there is a risk of complications. Usually, after an open phlebectomy, it is necessary to stay in the surgical hospital for at least 3-4 days, in some cases a little longer. Postoperative edema due to damage to the lymphatic vessels can persist for up to 3 months, and with damage to sensitive nerve fibers, numbness of the inner thigh and lower leg can last up to 6 months. Almost always, after an open phlebectomy, “large” hematomas form on the thigh due to the “torn away” inflows from the large saphenous vein.
The main disadvantages of open surgery:
- Narcosis and all its possible consequences
- Large cuts and seams
- Bed rest in a surgical hospital (risk of deep vein thrombosis)
- Swelling and hematomas on the lower limb
- Possible numbness and paresthesia of the thigh and / or lower leg
- The need for strong antibiotics and antiseptics to prevent suppuration of sutures
- "Ugly" scars (scars) after removal of stitches
Classical phlebectomy was replaced by microflebectomy techniques according to Muller, Creton, Oesch, Varady and others, which were modified over time and improved surgical instruments. These manipulations are performed without anesthesia, under local "tuminescent" anesthesia through micro-punctures in the skin up to 2 mm. and under constant ultrasound monitoring.
In the AngioLife vascular center, only minimally invasive methods of treating varicose veins are used: endovenous laser coagulation, radiofrequency obliteration, microflebectomy, sclerotherapy, etc. All manipulations are performed strictly according to the protocols of European phlebological clinics in compliance with international recommendations of the associations of phlebologists and vascular surgeons.