Surgical techniques in the treatment of varicose veins

Abstract

This chapter describes the surgical techniques in the treatment of varicose veins. Varicose veins are often asymptomatic, but the sensation of heaviness of the legs and chronic aching in the calves may be so severe as to require treatment. The other symptoms that cause patients to seek advice are night cramps, restless legs, localized pain, and tenderness over incompetent perforating veins, even in the absence of phlebitis. Itching and irritation of the overlying skin may occur. Any one of these symptoms may be severe enough to require treatment by surgery. The veins are marked with the patient standing using a black or blue fine-point felt pen, the sites of maximum discomfort being marked with a circle so that special attention may be given to the underlying vein. It is found that if the veins are extensive in one leg, both legs are not operated on unless the contralateral limb is only slightly involved. This is because an extensive procedure on both sides will hinder the postoperative walking ability and will involve an unjustifiably long anaesthetic. The saphenous vein and its tributaries are identified by blunt dissection, remembering that it lies much more superficially in the male.