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Phlebosurgical procedures are typically employed to treat chronic varicose veins. Most commonly affected are the v. saphena magna and/or the v. saphena parva, often in conjuncture with a defect and insufficiency of the valves leading into the deeper veins. In many cases, also the vv. perforantes are affected. Varicose veins do NOT merely represent a cosmetic problem, but may lead to distinct skin changes later in life, as they persist over many years.
Principle:
Various surgical procedures exist for the therapy of chronice venous insufficiency and are carried out according to the sate and severity of the disease.
After performing tumescent anesthesia, an incision is made at the juncture of thigh and inguinal area, to then find the opening of the v. saphena magna into the femoral vein. Subsequently all branches of the femoral vein are ligated,then a metal rod is fed into the v. saphena magna (proximally to distally), which is fixed and after ligation of the perforating veins and insufficient branches, teh vein si stripped (stripping of varicose veins).
Immediately postoperatively, a compression therapy with individualised compression stockings should be carried out which should be continued for 2-3 months after the operation.
It is furthermore of utmost importance to instruct the patient to walk a lot, as mobilization is the key to a fast recovery.
