Surgical Treatment of Varicose Veins

Surgical treatment of the varicose veins requires interruption of the reversed flow from the deep veins to the superficial through the faulty valves, in addition to removing the obvious varicose veins.

Preoperative Work-up

You will be assessed by Mr Bell in one of his consulting rooms. This will involve a history and physical examination of your legs. It is highly likely a venous duplex ultrasound will be perfomed to help in planning treatment.

On the day of Surgery

You will be given instructions on the timing of admission. In most cases admission will be on the day of surgery, but if there is any change from this, Mr Bell’s team will inform you accordingly.

Be aware that you should continue your regular medications, except for blood thinners which may need to be ceased 48 hours prior to surgery. You will be advised accordingly.

Your anaesthetist will see you prior to the operation and will discuss the anaesthetic aspects with you in detail.

Be prepared to stay overnight.

The operation

The procedure generally lasts an hour or so, depending on the extent of the varicose veins.

In order to interrupt the reversed flow due to faulty valves, a small incision is made in the groin in most patients. The long saphenous vein is detached from the deep (femoral) vein. In some patients, where the problem may arise behind the knee, the incision is made there. The long saphenous vein is usually removed or “stripped’ to reduce the chances of the veins returning. This can produce bruising on the inner thigh.

The varicose veins, which are marked with a felt pen prior to surgery, are removed by a series of tiny “stab” incisions, which are generally closed with steri-strips (tape). The leg is bandaged to reduce bruising and swelling.

Post-operative Course:

In most cases, the bandages are removed the following morning by the nurse and replaced with compression stockings. These stockings need to be worn continuously for 14 days, taken off only to shower. You can safely shower over the steri-strips which will gradually come off themselves.

I encourage you to do as much walking as you can manage. You will also require simple analgesia such as Paracaetamol and/or Nurofen.

An appointment will be made for review by Mr Bell, 2 weeks following surgery.

NOTE: If you have any concerns, phone Northwestern Vascular for advice.

What are the complications of surgery?

Bruising: Some bruising is inevitable following surgery for varicose veins. This is usually most prominent on the inner aspect of the thigh from where the long saphenous vein has been stripped. Not uncommonly, patients notice residual tender lumps at the site of previous veins, which generally disappear with time.

Wound infection/collection: It is uncommon to develop a wound infection or fluid collection (lymphocoele), though this is far more likely with redo (revision) surgery for recurrent veins.

DVT: The incidence of Deep Vein Thrombosis (DVT) is exceedingly low (less than one in 500).

Residual Veins: It is important to emphasize that complete eradication of ALL veins can NEVER be guaranteed. 

Haemosiderin Staining: Occasionally we see staining (a brown pigment) which has the appearance of a bruise and may take several months to disappear

Recurrent Veins: Even in the very best hands, a number of patients (10-15%) will develop recurrent veins in due course.

NOTE: If you require more information in regard to Varicose Veins and the procedure, contact our team at Northwestern Vascular.