Safenectomy: how it is done, risks and recovery

Surgery to remove the saphenous vein, or saphenectomy, is a surgery indicated for the treatment of varicose veins when there is excessive dilation of the saphenous vein, or when this vein no longer works as it should to return blood from the legs to the heart. , for example.

The saphenous vein is a large vein that begins in the groin, passes through the knee, where it divides into two smaller veins, which continue to the feet. Despite its size, removing the saphenous vein is generally not harmful to health, as there are other, deeper vessels that also contribute to the return of blood to the heart.

Saphenectomy is performed in the hospital by an angiologist or vascular surgeon and full recovery usually takes about 2 to 3 weeks. Additionally, during this period, the use of elastic stockings and pain relief medications, such as anti-inflammatories or analgesics, may be recommended.

When surgery is indicated

Saphenectomy is generally indicated in cases of:

• Persistent pain or swelling in the legs;
• Risk of rupture of the saphenous vein;
• Frequent wounds or ulcers on the legs;
• Difficulty healing wounds on the legs;
• Formation of clots within the saphenous vein;
• Very dilated varicose veins making blood circulation difficult.

The indication for saphenectomy by an angiologist or vascular surgeon may vary according to the severity of the varicose veins and the risk of complications such as thrombosis and bleeding. For this reason, it is very important to consult an angiologist or vascular surgeon, who are experts in treating varicose veins. Understand better who you should consult to treat varicose veins.

How to prepare for a saphenectomy

Some precautions are important to prepare for saphenectomy, such as clarifying all doubts about the surgery and recovery with the doctor and informing about all medications, vitamins and nutritional supplements used daily.

Before performing surgery, the doctor usually recommends imaging tests, such as an ultrasound of the legs, which can show changes in the veins and blood circulation, and blood tests, such as a blood count and coagulogram, to assess the general health status. and blood clotting.

How saphenectomy is performed

Saphenectomy, also called saphenous vein stripping, is performed by an angiologist or vascular surgeon in the hospital, with spinal or general anesthesia, and lasts about 2 hours.

Before starting the surgery, a catheter is placed to administer saline solution, medications and also for the anesthetist to perform anesthesia or sedation.

During a saphenectomy, the surgeon typically makes a small cut in the groin and others in the calf and ankle. Then, through the cut in the groin, the doctor inserts a thin plastic tube into the saphenous vein, called a phleboextractor, until it reaches the cut made in the ankle. This tube is then tied to the saphenous vein and pulled through the cut in the ankle, removing the damaged saphenous vein.

At the end of the surgery, the doctor closes the small cuts with stitches, where he places bandages, and the leg is bandaged, or elastic compression stockings are placed.

What is recovery like after saphenous vein removal?

Recovery from saphenectomy usually takes 2 to 3 weeks, however, this time can vary depending on whether it was performed on one or both legs.

In general, some important recommendations to help with saphenectomy recovery are:

• Rest as much as possible in the first 3 to 4 days after surgery;
• Keep your legs elevated with the help of pillows when lying down or a stool when sitting;
• Taking medication to control painsuch as anti-inflammatories or analgesics, at the right times as indicated by the doctor;
• Change the dressingas instructed by the nurse, taking care to always wash your hands before and after changing the dressing;
• Use elastic stockings for compression of the legs, as recommended by doctors;

• Not doing physical exercise or expose yourself to the sun for 1 month.

Furthermore, it is important to keep the stitches clean and dry, and use ointments to relieve bruising, such as hirudoid ointment, for example, as recommended by your doctor.

Possible complications

Saphenectomy is a surgery with few risks, however it can have complications such as:

• Dor;
• Scar infection;
• Bleeding;
• Thrombosis in the legs;
• Hematoma;
• Injury to nerves close to the saphenous vein;
• Pulmonary embolism.

In addition, an allergic or anaphylactic reaction to general or spinal anesthesia may occur. See all the risks of general or spinal anesthesia.

Therefore, if the saphenous veins are still functioning, it is generally recommended to avoid removing them, as the saphenous vein is useful for performing a saphenous bypass, if necessary, which is the surgery in which the saphenous vein is used to replace the saphenous veins. clogged coronary arteries of the heart. See other surgery options for varicose veins that preserve the saphenous vein.