VARICOSE VEINS SURGERY

What are varicose veins and How do they form?

Varicose veins are formed when a vein or its valves suffer from some damage and starts to lose its rigid shape. The walls of the vein loosen and become tortuous, leading to blood stagnating in the vein, further compounding damage. The manner and reasons for damage to the vein are numerous and can range from hereditary factors to even other underlying diseases. Here, at the Home of Healing Surgical center, Dr. Rengan will make sure that we rule out all serious conditions before advising you further.

Where are varicose veins found? How do I know if I have them?

The veins that are most often affected by this condition are the superficial veins of the leg, i.e., the veins that are closest to the skin. This is because the lower limb veins are the ones working hardest to push blood against gravity and repeated stress from various risk factors that lead to these being easily damaged. However, varicose veins can occur in any part of the body as well, even in non-visible parts. Initially, varicose veins usually do not cause discomfort.

You might only notice them looking more prominent on the skin, looking dark or purple in color or like cords under the skin. However, if they develop further, they might start causing more significant symptoms like:

• Swelling of the lower legs, especially around the ankle and feet.
• Pain, usually cramping or throbbing.
• Shiny or discolored skin around the vein.
• Dryness and itching of the skin of the leg.

It is best to get them treated at least by this point as otherwise; they could lead to more serious complications.

I thought varicose veins were common. Can they really cause serious complications?

Although varicose veins are common, complications are thankfully, not very common. Some of these complications are ulcers and blood clots. Ulcers happen usually near the ankle and often over a discolored area. This is thought to be because of the stagnated blood in the veins causing decreased oxygen supply and increased release of toxins in that area. Once you notice a sore develop, it is best to get it treated right away before it leads to a bigger infection.

Blood clots happen due to the stagnation of blood as well. They lead to pain and swelling of the limb and usually, that is when people seek medical attention. Rarely, with severe varicose veins, the deep veins might also be affected. If blood clots form in those veins, it causes a condition called deep venous thrombosis (DVT). DVT is a serious condition as the blood clot can dislodge and travel elsewhere like the lung where it can again get stuck and cause a life-threatening emergency called a pulmonary embolism. This is why Dr. Rengan at our center makes sure to assess the extent of the varicosities so that you can be stress-free and receive the most appropriate treatment.

Risk factors of varicose veins

There are many reasons for varicose veins and sometimes, there may even be no apparent cause. Some of the known risk factors are:

• Increasing age
• Female gender
• Obesity
• Smoking
• Family history of varicose veins
• Pregnant/recently pregnant
• The use of birth control pills
• Previous injury or trauma to the vein or leg
• Prolonged sitting
• Prolonged standing (even us surgeons commonly suffer from this!)
• Underlying diseases like blood or clotting disorders, liver diseases, etc

Do not worry, because, no matter the cause, varicose veins can be treated successfully.

Do I definitely need to have surgery done?

If you have mild varicose veins, you can try some self-help measures like elevating your feet, avoiding tight pants or high-heels, and modifying some of the risk factors mentioned above by exercising, diet changes, and avoiding being in the same pose for a long time. Compression stockings were used to relieve symptoms but nowadays, it is recommended that varicose veins be definitively treated if they are causing pain and other problems. Varicose veins that develop during pregnancy generally improve without medical treatment within a few months after delivery. Whatever your case, Dr. Rengan will decide your type of treatment after evaluating all factors involved and give you guidance on prevention as well

Why choose Dr. Rengan for varicose veins surgery?

First, Dr. Rengan will have a detailed conversation with you to know about your symptoms and medical condition, followed by a detailed physical exam. A non-invasive test (no needles!) by Doppler ultrasound will be performed to assess the extent of the varicose veins and to see if there are blood clots or not. The test will be performed by a radiologist at a designated scan center. Based on all these findings, an appropriate treatment plan will be drawn out for you. If surgery is planned, further discussions regarding that will happen & some more detailed tests and examinations will be done as well.

What are the surgical options for varicose veins surgery?

We provide both traditional surgery as well as newer techniques that are less incisive. The decision on the type of procedure will be made after a detailed perusal of your condition and overall health.

Traditional surgery involves making an incision over the skin to cut and strip away a section of the vein that is causing the problems. The operation can be done in the hospital and you can get discharged in a day. The traditional operation is not done regularly, however, there are still some uses. In select patients, traditional surgery is more effective.

Newer techniques like radiofrequency ablation involve placing a thin tube into the vein and heating the tip of the tube to collapse the vein completely and make sure it doesnt balloon out anymore. Dont worry about the loss of these sections of veins as the deep veins supply our legs adequately even without them. Dr. Rengan will explain to you the procedure in detail first and you can take time to think about it and as questions. Our center prides itself on maintaining a patient-first approach and you can be assured will be involved in every step of decision making.

LASER surgery for varicose veins, What is it?

The use of modern lasers in varicose veins surgery has revolutionized the treatment. We have 2 types of what-is-termed as lasers in use:

• Endovenous Laser Ablation (EVLA)
• Radio Frequency Ablation (RFA)(EVLA)

Both methods are similar in efficacy but the RFA is more commonly used because of ease of use. Dr. R S Rengan performs a high number of laser varicose vein surgeries every year with very high success rates.

What happens after the surgery and Will I be in pain?

After the procedure, you will be given the appropriate medication for pain control. We will also give you some other medicine to reduce infection and the risk of clotting if appropriate for your situation. Since this is a mostly uncomplicated procedure, you can go home on the day of the procedure itself with our advice. We will also give you instructions to follow to care for the site of surgery and the date of the review. Rest is an essential part of recovery and make sure not to strain yourself. Compression stockings will be given to you for postoperative care and it is quite important in aiding recovery. Elevating your legs is also beneficial post-operatively.

At your review, we will not only evaluate the postoperative area but also give you further instructions on how to prevent recurrence in the future including lifestyle change recommendations. Dr. Rengan will be free to take your calls anytime. He has an able team who will be visiting you at the hospital on the night of surgery.

Is there anything I should not do after the surgery?

This is a mostly uncomplicated procedure and does not come with immense lifestyle restrictions. However, in the recovery period, avoid vigorous exercise to give your leg time to heal. Mild stretches can be helpful and are even recommended for some patients, but any sort of vigorous activity should not be done. Another thing to avoid is exposing the areas to heat (like a hot shower or hot compress) for at least a week. Lastly, it is highly recommended to avoid flying for a short period of time after surgery. If taking a flight is required, do come back to our center before embarking on it so we can guide you appropriately.

Find an experienced surgeon to treat your varicose veins problem. Dr. Rengan is an experienced varicose veins surgeon who has an experience of more than 30 years in treating this problem.