Vein Surgery

Vein surgery is the traditional method of treating varicose veins but in most parts of the world vein surgery is being replaced by non surgical techniques such as endovenous laser ablation and ultrasound guided sclerotherapy.

Vein surgery typically involves tying the great saphenous vein (GSV) close to where it joins the deep vein system to prevent backflow of blood down the incompetent GSV.  The thigh component of the GSV and it's associated varicosities are then stripped out through multiple stab avulsions.  The procedure is typically carried out under general anaesthesia and most patients can now mobilise fairly quickly.

There is a higher incidence of complications with vein surgery, compared to non surgical techniques, such as wound infection, nerve damage, deep vein thrombosis and damage to lymphatics.  The post operative recovery is typically slower with surgery than non surgical procedures.   Given that vein surgery is less effective and with more complications than endovenous laser ablation in three to five year data, it is not surprising that many patients are looking at the non surgical options.

Vein surgery on the small saphenous vein (SSV) is particularly disappointing because of the difficulties of operating in the popliteal fossa where there are many nerves and arteries associated with the SSV.  Some studies have demonstrated a failure rate at five years as high as 50%.