Outpatient Varicose Vein Surgery

How do varicose veins form?

In the legs, there is a double venous system: the deep one, which carries the circulation bone, and the superficial one, which is constituted by the internal saphenous and the external saphenous with its branches. Varicose veins occur in the superficial venous system.

The human being, when standing, has to fight against the law of the earth’s gravity, which tends the blood to go to the foot, instead of to the heart. To avoid this, we have sigmoid valves that are at different heights along the venous system, to fragment the weight of the blood circulation and force it to flow upwards towards the heart.

Can they cause disorders?

Initially it is a benign disease that gives little symptomatology. Over the years, the varicose veins grow and the symptoms of venous insufficiency appear. We measure this clinically according to the CEAP scale, which combines Clinical, Anatomical Extent and Physio-Pathology on a scale of one to six.

In the initial stages, there are telangiectasias, varicose veins and uncomplicated varicose veins, which are mainly of aesthetic interest. Subsequently, edema and trophic skin disorders appear, leading to varicose ulcers in the final stages five and six. In addition, episodes of thrombophlebitis and varicorrhages can occur, which are hemorrhages due to rupture of the vein through the skin.

What does outpatient surgery and microfoam treatment consist of?

It consists of ligating the saphenous callus and its branches, through a small incision in the inguinal crease, the saphenous vein is not removed, but a phlebotomy or removal of the varicose branches is performed with the help of a small hook. The skin incisions are minimal, there is hardly any surgical trauma and no stitches are required in the skin.

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Recently we have modified the technique by introducing micro-foam, we mix the ethoxysclerol liquid with gases, such as ambient air or CO2 forming a small whitish foam. This foam is injected into the varicose veins and its small micro-spheres diffuse along the varicose veins producing a vasospasm and occlusion of all varicose veins. In our practice we use ethoxysclerol foam alone for the treatment of small to moderate varicose veins and spider veins.

What are the advantages of using this type of treatment?

This minimizes the surgical aggression that usually consists of one or two small incisions. The patient returns home the same day of the intervention, requires some elastic containment consisting of an elastic bandage, or an elastic stocking to prevent edema of the limb, the next day you can walk with minimal discomfort without requiring postures or rest, beyond normal. Depending on the extent of the varicose veins, a week off work may be required, but in many cases it is not necessary. There are no skin stitches to be removed. It is necessary to continue with an elastic stocking for a few weeks to prevent the appearance of edema. The use of low molecular weight heparins or other medications is also not necessary, except for sporadic analgesics.