Classical vein surgery – Stripping
In a classical surgical procedure, a complete flow of the great superficial vein – saphenous vein – is removed physically, by tearing. In 1907, Dr Babcook performed the procedure in that manner for the first time; up until nowadays, the principle has remained the same, with the advancement of the technology.
Description of the procedure
The technique consists of pulling the cord through the superficial vein, and its extraction through the cut in the groin, after the ligation of the confluence of the superficial in the deep vein – crossectomia. Ligature closes the main superficial venous valve which had weakened and causes disease. However, this technique is slowly being thrown out of practice due to the intense postoperative pain and a high percentage of relapse.
Candidates
Varicose veins due to the weakened venous valve in the groin.
The method is performed correctly in most of the hospitals, financed by the Croatian health insurance fund (‘with a referral’).
It requires several days of hospital stay and preoperative preparation.
Preparation
Preoperative testing, heart/lungs X-ray, ECG, preoperative anesthetic examination.
Course of the procedure
The procedure is done under general or spinal anesthesia.
A crossectomy – ligation of the confluence of the superficial – saphenous vein, and her inflows, into the deep vein.
Through a cut on the groin, a plasticized probe is lead into the saphenous vein up to the weakened confluence and it is removed, ‘stripped’. Cuts are stitched, and an elastic bandage is wrapped.
Recovery
Postoperative recovery is significantly longer than with endovenous techniques – it requires 6-8 weeks of wearing a compress. Postoperative pain lasts for about 3 months; it is quite intense during the first ten days due to the development of a hematoma at the place of the extracted vein. Postoperative leg swelling, hematoma, and pain in the area of surgical wounds are also present.
Precautions and limitations
It is not performed with varicosities of 5th and 6th stage – damaged skin and existing vein ulcer.
Ulcer should be first closed using an occlusive bandage.
With an experienced surgeon and modern instruments, it can be cosmetically and functionally acceptable.
Side effects and complications
Short-term functional results are always satisfactory, but long-term, there is up to 40% of relapse – return of the disease.
Package
Package includes: preoperative examination by an anesthesiologist, surgery under general intravenous anesthesia, postoperative stay under supervision in a suite up until a condition fit enough for a medical discharge, adequate elastic socks fit to the 2nd level of compression, medicines necessary during and after the surgery, 3 postoperative reviews with an additional sclerosation of the treated vein flow, if necessary.
Package does not include: first indicative surgeon’s examination, vein color Doppler, blood test results, ECG, preoperative examinations by other specialized doctors due to comorbidity (pre-existing personal conditions, such as: diabetes, asthma, heart, high blood pressure, lungs, thyroid gland, allergies, etc.). Also, it does not include price for additional overnight stay (if necessary), expenses made expenses made prior to admittance into Polyclinic Lege Artis, telephone expenses, customary therapy.
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