Stripping is the surgical removal of varicose veins by the vein doctor using a special probe. The diseased veins are pulled out of the affected area during stripping. The risks of the procedure include, in particular, lymphatic congestion due to injured lymphatic vessels.
What is stripping?
Stripping is the surgical removal of varicose veins by the vein doctor using a special probe. Stripping is an operation to remove varicose veins. The procedure is also known as vein stripping. This surgery is the standard treatment for patients with varicose veins. Varicose veins are nodular dilated veins. Mostly the veins of the legs and their main trunks are affected by the phenomenon. About 30 percent of all people suffer from varicose veins and thus have an increased risk of thrombosis and circulatory disorders. In the course of time, the circulatory disorders can possibly damage the entire leg. The removal of varicose veins is usually essential because of these risks. Mainly truncal varicose veins are removed via surgical stripping. All dilated and altered veins are removed from the superficial venous system. Stripping has been used since the beginning of the 20th century. In the meantime, however, there are also minimally invasive options for removing varicose veins. One example of such a method is the Chiva method.
Function, effect and goals
Stripping frees patients with varicose veins from nodular dilated veins. To determine a treatment method for varicose veins, the patient is first thoroughly examined by the vein doctor. This examination mainly includes ultrasound procedures and vein function tests. Unsuitable for stripping are, for example, patients whose inner leg veins are affected by functional disorders. The same applies to patients whose varicose veins have a thrombotic cause. Stripping is also generally not recommended for patients with more severe general diseases. In women who are pregnant, stripping is usually postponed to rule out any risks. Once the decision is made to perform stripping for truncal varicose veins, the patient is placed under general anesthesia, partial anesthesia, or local anesthesia. Which form of anesthesia is used and whether hospitalization is required depends on the patient’s mental state and the severity of the findings. Depending on the position of the varicose veins, after anesthesia the surgeon makes an incision about five centimeters long either in the groin region or the back of the knee. This incision serves as an access to the venous system. Through the access, the doctor locates the junction of the knotted vein with the deep vein. This confluence is interrupted. Similarly, orifices of smaller blood vessels into the affected region are interrupted. The physician then inserts a special probe through the incision, which corresponds to a thin wire. This thin wire is advanced through the incision into the diseased area. A second skin incision allows the wire to pass back out. The affected vein is now fixed to the probe. Only then does the actual stripping take place. The fixed vein is pulled out of the leg towards the bottom. Smaller side branches with pathological changes are then removed through tiny skin stitches. After stripping, the doctor closes the access. He usually uses a self-dissolving thread for this purpose, which is sutured under the skin. For three to six weeks after stripping, the patient wears compression stockings to prevent thrombosis. In most cases, the patient also receives anticoagulant treatment with heparin, which lasts for several days. Under certain circumstances, varicose veins may form again after stripping. According to studies, the recurrence rate is related to the professionalism of the operating physician. For example, recurrent varicose veins often result from an incompletely removed truncal vein.
Risks, side effects, and hazards
Stripping leaves visible scars because an incision of five centimeters is required for the surgery. Although the incision is made in discrete regions, the permanent scars still often move patients today to prefer minimally invasive varicose vein treatments. Procedures such as the Chiva method have some advantages over stripping in terms of scarring.Like any other operation, stripping is associated with risks such as wound healing disorders, infections or bruising and associated induration. In addition to these conventional surgical and anesthetic risks, stripping additionally involves risks such as lymphatic or nerve injuries. If the lymph vessels of the affected region are injured, for example, a congestion of lymphatic fluid can occur. As a result, the leg swells and the fluid may need to be drained. On the other hand, if nerves are injured during surgery, sensory disturbances may occur in the affected area. Mild numbness often occurs, but this usually resolves. Overall, the risk of complications with this surgery is considered to be extremely low. A slight pain may occur after the operation. Apart from this phenomenon, however, side effects are extremely rare, as the operation now corresponds to a standard procedure. The risk of clots in the corresponding vein sections is kept low, for example, via procedures such as compression therapy. However, not wearing the compression stockings could be associated with serious consequences and promote thrombosis. Since self-dissolving sutures are usually used to close the incisions during stripping, the patient does not usually need to have sutures removed after the operation. Nevertheless, follow-up appointments are scheduled to check wound healing.