Vein Surgery and non-surgical alternatives
Vein surgery explained
There are two types of surgical vein procedures:
1) Vein Stripping - an invasive procedure performed under general anaesthesia in hospital.
In this procedure the surgeon makes two incisions, one at the top of the affected vein in the groin and one in your calf or ankle. A wire stripper is then advanced through the vein, tied to the saphenous vein and pulled out, bringing the entire vein with it.
Vein stripping is not offered at the vein clinic as it is no longer considered the “gold standard” for treating saphenous vein reflux due to prolonged recovery time and high disease recurrence rates (up to 50% at 5 yrs).
2) Phlebectomy - a minimally invasive procedure performed under local anaesthesia as an outpatient at the vein clinic.
In this procedure, larger bulging surface veins are physically removed through small incisions placed over the veins. A small hook is placed through the incision to capture the vein and it is then gently removed through the incision. A surprisingly large amount of abnormal vein can be removed through incisions generally between 1-3mm in size.
Recovery after vein surgery
After vein stripping recovery is often prolonged and uncomfortable with patients generally requiring one to two weeks off work.
After Phlebectomy recovery is rapid and usually associated with minimal discomfort, return office based work the following day is often possible.
Alternatives for vein surgery
Organisations such as the Australian and American Colleges of Phlebology, American Venous Forum, International Union of Phlebology, now recommend more modern techniques such as laser and radiofrequency ablation.
The National Institute for Health and Care Excellence (NICE) in the United Kingdom, included this in their 2013 Guidelines:
Exercising, losing weight, avoiding tight clothes, elevating your legs, and avoiding long periods of standing can lessen pain and may help slow the progression of varicose veins from getting worse but will do nothing to get rid of varicose veins once established. In some instances where the veins are very superficial and very extensive surgery may be a reasonable option. It is recommended that before you commit to having surgical treatment of your veins you seek a second opinion from a vein specialist experienced in non surgical treatments such as endovenous laser and ultrasound guided sclerotherapy.