Combined phlebectomy (vein ablation)

Combined phlebectomy (vein ablation)

Combined phlebectomy is the most common surgical method of varicose vein treatment. It involves ablation of pathologically changed (affected) veins using specialized equipment and different surgical manoeuvres. During the surgery, only subcutaneous veins are ablated, which do not disturb the work of the human blood circulatory system.

Vein ablation not only provides treatment result, but also improves appearance of the legs.

What is combined venectomy:
Combined phlebectomy can include crossectomy, stripping, supra- and subfascial perforating vein surgery, collateral vein surgery.

The surgery is performed under general and conduction anaesthesia. In rare cases, it can be performed under local anaesthesia.

The main goal of varicose vein disease treatment is to eliminate pathological reflux (abnormal venous blood flow). In crossectomy, the great vein and its branches are ligated at the site of inflow into the deep vein. Affected veins are ablated with the help of special sounds. Perforating veins are ligated above or under the fascia under ultrasound guidance.

Duration of the surgery: 1-2.5 hours

Rehabilitation: 1-2 weeks

Our approach to the surgery:

  • Surgical extent is determined based on clinical and ultrasound examination results.
  • Before the surgery, mapping of the affected veins is performed under ultrasound guidance.
  • Unique instruments and suture materials are used to achieve the maximum cosmetic effect.

Medical indications for the surgery:

  • Presence of pathological reflux in the superficial veins of the lower extremities confirmed by duplex ultrasound.
  • Ascending thrombophlebitis on the hip.

Surgical methods:

  • Crossectomy is a ligation of the affected vein and its branches through the small incision in the inguinal fold (2-3 cm).
  • Stripping is a complete or partial ablation of the great or smallsaphenous vein with the help of special sounds.
  • Supra- and subfascial perforating vein surgery is an ultrasound-guided procedure performed through punctures or small incisions (2-3 mm).
  • Collateral veins are ablated through punctures with the help of special hooks.

Self-preparation for the surgery:

  • In two weeks before the surgery, it is necessary to stop taking hormonal drugs. If it is impossible, it is necessary to coordinate further actions with the doctor.
  • 2 days before the surgery, it is necessary to stop taking anti-inflammatory drugs.
  • It is necessary to take a hygienic shower in the morning and wash legs with regular soap.
  • It is necessary to appear at the clinic in fasting state wearing comfortable, loose clothes and shoes.

Specific aspects of the postoperative period

  • Postoperative day is spent at the inpatient unit under the care of a doctor.
  • Within the first week, round-the-clock use of compression stockings is indicated.
  • Within about one month, active sports are not recommended, however, active movements are desirable.
  • Within the following 2 months, daily use of medical compression garments is recommended.
  • Within 2 months, veinotonic administration is recommended on medical indications (drugs that improve the venous network tone). It is not recommended to attend steam bath, sauna, solarium, or to undergo thermal procedures.
  • 2-3 months after the follow-up ultrasound, surgery results and indications (if present) for additional correction (microphlebectomy, sclerotherapy) are evaluated.

What is the course of rehabilitation:

Day 2 discharge from the clinic.
Day 8 start of use of compression stockings or tights during a day.
Month 1 gradual coming around to active sports.

Vocational rehabilitation takes 1 to 3 weeks depending on the surgery extent and work activity nature.

Consultation before the surgery:
The consultation takes about 1 hour. It involves as follows: ultrasound diagnostics, discussion of surgical indications, surgical extent and special aspects of postoperative period with phlebologist. The doctor examines your disease history, previous traumas and allergic reactions.

To ask questions, please contact us at: +38 (044) 499-70-00