Varicose Veins Surgery in Dakshina Kannada

Traditional varicose veins surgery in Dakshina Kannada is a conventional surgical method of treating varicose veins. Varicose vein, or Varicosis, is characterized by enlarged, swollen, gnarled (twisted) veins seen superficially on the skin of your lower legs. They are commonly found around your ankles, inner thighs, knees, and the calves of your lower legs. The treatment for varicose veins includes self-care measures (avoid long periods of sitting or standing, limit salt intake), lifestyle changes (regular exercise, maintaining a stable weight), and compression stockings for mild cases, while more severe cases require surgical intervention. Surgical intervention includes traditional (open) methods (vein stripping) and newer methods like sclerotherapy, laparoscopic, laser, and endoscopic vein surgery in Dakshina Kannada.

Traditional varicose veins surgery in Dakshina Kannada is a conventional open operation to treat varicose veins. Popularly known as "Vein Ligation and Stripping," this a method for surgically removing the affected vein (varicose vein) from the legs or knees. Varicose veins are bluish-purple or green veins that often occur due to the abnormal stretching of the valves of the vein. These veins contain a one-way valve that opens to allow blood to flow through them and then closes to prevent the backflow of blood. When the vein walls and vessels weaken, it causes the blood to leak and flow backward. The blood pools within the affected veins causing them to enlarge and swell. Aging, family history, multiple pregnancies, obesity (being overweight), and prolonged sitting or standing may increase your risk of developing varicose veins. 

Varicose veins may present with prominent bulging veins, accompanied by pain, swelling, achiness, and a heavy feeling around the enlarged veins, depending on its stages. The stages of varicose veins include:

Stage 1- Initial stage with spider veins.

Stage 2- Veins begin to swell and give a rope-like appearance.

Stage 3- Veins are enlarged and inflamed but without skin changes.

Stage 4- Enlarged veins with skin discoloration.

Stage 5- Enlarged veins with healed skin ulcers.

Stage 6- Enlarged veins with active skin ulcers.

Traditional varicose veins surgery is an invasive procedure that involves large incisions or cuts (3 to 5 cm) through which a flexible plastic wire is inserted at one end of the incision. The wire is "tied off" (ligated) to the affected vein, and extracted (stripped) out from the other end of the incision. 

When conservative methods fail to provide relief from symptoms of varicose veins, your surgeon would recommend a traditional (open) surgery to treat them. It is recommended for e:

• Cosmetic reasons- Varicose veins appear as bluish-green or purple twisted and enlarged veins in your lower legs with a rope-like appearance that is unaesthetic. 
• To relieve symptoms- Varicose veins may cause severe pain, swelling, achiness, and heaviness of your lower legs, compromising your quality of life. Left untreated may also lead to ulceration and necrosis (tissue death).
• Chronic venous insufficiency (CVI)- Pooling of blood around the affected veins may cause blood clots that lead to severe pain, swelling, and skin sores. The blood clot formed is most often referred to as Deep Vein Thrombosis ( DVT). 

Varicose vein surgery may include invasive methods like traditional (open) surgery and minimally invasive procedures like laparoscopic, laser, endoscopic vein ligation, and radiofrequency ablation. The key differences between traditional and laparoscopic vein surgery are discussed below.

A traditional varicose vein surgery in Dakshina Kannada is usually an outpatient procedure (does not require hospitalization), depending on the severity and stage of the varicose veins. However, for severe cases, you may need an overnight hospital stay. 

Preparation

It is important to consult a vascular surgeon [a doctor specializing in treating vascular (blood vessels) diseases] when you notice any symptoms of varicose veins for further evaluation. 

Discuss your medical history with your surgeon, including:

• If you are suffering from any medical condition like asthma, diabetes (increased blood sugar levels), heart, thyroid, or lung diseases, or any blood disorders.
• If you are on any medications, which include blood thinners, anti-inflammatory drugs, or herbal supplements.
• If you are allergic to medications, anesthesia, or other substances.
• Your history of previous surgeries or accidents.

Your surgeon may put you through a series of tests to confirm the diagnosis, which includes:

• A Venous Doppler Ultrasound scan- To check for the presence of blood clots within your lower legs.
• A Colour Duplex scan- To check for the blood flows through your affected veins.

It is important to prep yourself before the procedure by following the instructions:

• Quit smoking and alcohol at least 1 week before the procedure.
• Discontinue medications like blood thinners for 2 weeks. 
• Fast for 8 to 12 hours before the surgery, if performed under general anesthesia (GA), to prevent aspiration of food particles into your lungs. 
• Arrange for someone to drive you back home since the anesthesia can make you drowsy.

Procedure

• On the day of your surgery, your nurse will check your vitals (blood sugar levels, blood pressure, urine output, pulse, heart rate, and oxygen level). 
• General anesthesia will be administered through IV (intravenous) infusion, which will put you to sleep during the entire surgery.
• The surgical site will be cleansed with an antiseptic solution to remove surface contaminants, thereby preventing the risk of post-op infection.
• With the help of a scalpel (a special surgical blade), your surgeon will make a large incision of about 3 to 5 cm near your groin area. 
• Another small incision of around 2 cm will be made near your lower leg (either in the calf or near the ankle). 
• The top of the affected vein will be dissected (cut open).
• A thin, flexible plastic wire will be threaded into the dissected part of the vein through the groin incision.
• The inserted wire will be tied (ligated) to the affected vein and pulled (stripped) through the other incision in the lower leg.
• The procedure will be repeated if more than one vein needs to be treated. 
• Your surgeon will then close the incisions with stitches and place surgical bandages and compression stockings on your operated leg. 
• The entire procedure would take around 60 to 90 minutes, depending on the severity of the condition and the number of veins stripped.

Aftercare

You will be observed for 1 to 2 hours in the recovery room until you regain consciousness, while your vitals are monitored continuously. 

• You may experience mild pain and discomfort in your operated leg once the effect of anesthesia wears off. 
• Depending on the severity of the varicose veins, you may be sent home the same day or made to stay overnight in the hospital. 
• Your surgeon will prescribe pain medications to relieve pain once you are back home.
• Refrain from taking a shower for at least 3 to 4 days.
• You will have to stay off your feet for the first 3 to 4 days after the surgery for proper healing.
• After this period, walking around to maintain good blood circulation is important.
• You must get your surgical bandages removed 4 days after the surgery.
• You must keep your legs elevated while sitting or sleeping to promote good blood circulation.
• You must wear your compression stockings until advised by your surgeon.
• Avoid lifting heavy objects or strenuous exercises and activities for a period of 4 to 6 weeks.
• Avoid traveling by air/train/car for over 4 hours for the initial 4 weeks following the procedure.
• You may be able to return to your normal activities by the fourth week.
• Complete recovery may usually take around 4 to 6 weeks.

A traditional varicose vein surgery in Dakshina Kannada is a safe and low-risk procedure with multiple benefits when performed by an experienced vascular surgeon. However, there are always some risks associated with surgeries. The benefits and risks of the procedure are listed below:

Benefits

• It is an outpatient procedure; hence you can go home the same day. 
• The affected vein is stripped out, so there is less chance of recurrence.
• It alleviates pain, discomfort, and heaviness, improving your quality of life.
• Helps treat any type of varicose veins, in addition to cases with CVI.

Risks

• Allergic reactions to anesthesia cause hives, rashes, dizziness, nausea, confusion, and breathing difficulties.
• Large incisions made will leave behind ugly scars.
• Formation of a lump under the wound if the incision is made in your groin.
• Numbness and tingling sensation around the operated leg due to injury to any nearby nerve.
• Infection at the incision site if it is not kept clean and dry.
• Risk of blood clots in your legs that may dislodge into the bloodstream and travel to other organs causing life-threatening complications (e.g., blood clots in the lungs can cause pulmonary embolism). 

A traditional varicose veins surgery is usually a safe and effective procedure to treat varicose veins with minimal post-operative complications when performed by an experienced vascular surgeon. It involves completely removing the diseased vein, with a success rate of up to 95%.

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