DAY-HOSPITAL SURGICAL TREATMENT OF VARICOSIS VEINS
We are talking of course about the primitive varicosis veins, or rather those of costitutional kind, almost always hereditary; we aren’t talking at all about the varicosis veins that follow thrombotic episodes, whose surgical treatment is very discussed.
Let’s clear that the big varicosis veins of the lower limbs are almost always caused (at least on 90% of the cases) by a saphenous incontinence, whose treatment is just only surgical.
Among all the various techniques that are proposed and often reproposed for the surgical treatment of the varicosis veins, we think that the best, or rather the one that produces less relapse, is the total and radical removal of the saphena.
Only the "complete" elimination of the saphena and the "radical" ligature of all saphena’s collaterales can reduce in an important way the possibility of relapse.
This sort of operation can be realised in local anaesthesia during day-hospital.
Let’s consider some details ...
First of all a precise diagnosis of saphenous incontinence must be defined with eco-doppler exams. We have to remember that the saphenas are four, two inner ones (or anterior) and two external ones (or posterior) and they have to be studied so as to individuate which one of the four is ill (or rather incontinent).
Then a local anaesthesia is performed with the blockage of the femoral nerve (this technique is less invasive than epidural anaesthesia) that allows the patient to walk even an hour after the operation.
Then we procede with the so called crossectomy (or better we tie all collateral veins of the saphena at the entrance to the deep venous circulation) to garantee the radicality of the
operation.
A complete stripping of the saphena is performed to up to down, after having done a little incision in the malleolar zone.
The operation is completed by microflebectomy of the saphenous ramifications, this is a technique that completes the operation and garantees an excellent aesthetic result.
Then we apply a good elastic-compression of all the lower limb that has to be kept for 24 hours (and will ther replaced by an elastic-stocking to wear only during the day for three weeks).
The patient then starts walking already after more or less an hour.
After an observation period of 6 hours, the patient go back to home.