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Varicose vein surgeryPublished by Bupa's health information team, June 2009. This factsheet is for people who are planning to have varicose vein surgery, or who would like information about it. Varicose veins are swollen superficial veins (veins that lie under your skin) that look lumpy and bluish through the skin. Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.
About varicose veinsVaricose veins usually affect the legs, particularly the calf and sometimes the thigh. They are caused by damage to valves in the veins. This means that blood can't travel up your veins as easily as it should and tends to pool in the leg. Varicose veins are very common and affect up to three in 10 people at some time in their lives. They are slightly more common in women than men. Varicose veins don't always need treatment as not everyone will get symptoms. Most people only find them a problem because of the way they look. However, your varicose veins won't get better without treatment, and they tend to get worse over time.
Diagnosis of varicose veinsYour GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may refer you to a vascular surgeon (a doctor specialising in blood vessels). Varicose veins are usually easy to see in your leg. However, your GP or surgeon may perform some tests to work out the how much valve damage you have and where exactly it is. What are the alternatives to varicose vein surgery?Depending on how severe your varicose veins are, your surgeon may recommend a non-surgical treatment for you.
Your vascular surgeon will advise you on which treatment is most suitable for you. Preparing for your operationYour surgeon will explain how to prepare for your operation. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery. The operation is usually done as a day case under general anaesthesia. This means you will be asleep during the operation. You will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand. At the hospital your nurse will explain how you will be cared for during your stay. Your nurse may check your heart rate and blood pressure, and test your urine. Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead. You will be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may also need to have an injection of an anti-clotting medicine called heparin. About the operationThe operation usually takes between 30 minutes and two hours, depending on the exact type of operation and whether only one or both of your legs are being treated. The most common surgical procedure for varicose veins is called 'ligation and stripping'. Your surgeon will make a small cut in your groin at the top of your leg. The 'faulty' valve is tied off (ligated), to stop blood flowing through it, and the "faulty" vein in the thigh is then carefully pulled (stripped) out of your leg through a separate small cut lower down in the leg. Small cuts may be made along your legs to remove individual smaller veins. This type of procedure is called avulsion or phlebectomy. Your surgeon will close the cut in your groin with dissolvable stitches. Smaller cuts are usually closed with 'paper stitches'. Your legs will then be tightly bandaged. After surgery, blood can still flow up your legs because the deeper network of veins is left untouched. How varicose vein ligation and stripping surgery is carried out
What to expect afterwardsYou will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You may also need to wear compression stockings on your legs to help maintain circulation for one week after your operation. You will usually be able to go home when you feel ready. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours. Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment. Dissolvable stitches will usually disappear in around one to three weeks, but this can take up to six weeks, depending on the type of stitches you have. Non-dissolvable stitches are usually removed around seven to 10 days after surgery. Recovering from varicose vein surgeryIf you need pain relief, you can take over-the-counter (OTC) painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice. The recovery time for your operation will depend on whether you have had one or both of your legs treated and the exact procedure used. You will need to take it easy for several days and not do any strenuous exercise, lifting or carrying. It's important that you don't stand still for long periods of time for the first few weeks after your operation, and when you sit down, your feet should be higher than your hips. This helps to prevent swelling in your legs and reduces the pressure on your wounds. General anaesthesia can temporarily affect your coordination and reasoning skills, so you shouldn't drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. Follow your surgeon's advice about driving. You shouldn't drive until you're confident that you could perform an emergency stop without discomfort. This is usually about one week after the operation. Your surgeon will also advise you on a suitable date for returning to work. What are the risks?Varicose vein surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure. Side-effectsThese are the unwanted, but mostly mild and temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic, swelling/pain around wounds, or scarring. Possible side-effects of varicose vein surgery include:
ComplicationsThis is when problems occur during or after the operation. Most people aren't affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, or DVT). Possible complications of varicose vein surgery include the following.
Although many people won't need any further treatment, around three in 10 will develop more varicose veins within the next 10 years. The exact risks are specific to you and differ for every person, so we haven't included statistics here. Ask your surgeon to explain how these risks apply to you.
Related topics
Further information
Sources
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: June 2009
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The deep and superficial veins of the leg
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