Vein Solutions performs many varicose vein procedures every year. Grace Huma, a 43-year-old computer specialist, shares her varicose vein removal experience, and her Vein Solutions surgeon in Chester, UK, explains the procedure.
Patient Grace Huma:
Over the last few years, I’ve been watching the veins on my right leg protrude more and more. They weren’t hurting, so I continued to postpone seeing a doctor. But the veins were itchy and unattractive, starting above my knee and then wrapping around the back of my knee. The problem was most noticeable on long walks, when I was on my feet for an extended time and when I wore compression underclothing beneath some of my dresses.
I recently asked my general practitioner about the itchy, swollen veins and discomfort. My problem wasn’t serious enough to require an NHS varicose vein operation, but I do have private medical insurance. So, I requested a referral to a reputable vascular surgeon, and I saw Mr Sameh Dimitri later that week. I chose Consultant Vascular and Endovascular Surgeon Dimitri because he specialises in vascular surgery in the Mersey region (Wirral, Liverpool and Chester), and he offers minimally invasive treatments for vein issues. Plus, he trains and runs courses for other surgeons on new vein treatments.
Mr Sameh Dimitri examined my legs and completed an ultrasound scan. He immediately explained to me that the blood wasn’t flowing properly through my veins, and he recommended that I have the vein surgically removed. He explained that the treatment would require the use of a general anaesthetic and that he would make small incisions down my leg to remove bits of my bulging varicose veins.
I felt confident that Mr Sameh Dimitri would do a great job, and I decided to go for it! I went into the hospital for the operation the next week and arrived a few hours before my operation. I was excited as I considered being able to live without the discomfort that the veins caused and being able to wear shorts and skirts without being embarrassed.
The anaesthetist came in first to find out if I had allergies to anything and to have me sign consent forms for the operation. I felt comfortable with the entire process, felt that my needs were a priority and I felt safe.
Next thing I remember is waking after the operation was completed, my leg was initially more bothersome and uncomfortable than I had anticipated. But within just a couple of hours, the pain was diminished. When Mr Sameh Dimitri removed the bandages the very next day, my leg looked bruised but ok.
Day two, I was resuming my regular schedule and walking freely with a limp. Over the first week, my leg remained swollen, bruised and very sore. But, there was a progression of less pain each day. I followed all of the post-operation instructions, and I kept my leg elevated as much as possible. Two weeks later, the incisions were all healed, and I had some yellow and black bruising. But, within a month, the bruising was gone, and the vein was no longer seen.
Mr Sameh Dimitri, Consultant Vascular and Endovascular Surgeon
Mr Dimitri is a Consultant Vascular and Endovascular Surgeon at Vein Solutions and offers vascular services through a number of private hospitals located in Chester, Wirral, Manchester and North Wales. Mr Dimitri explains the vascular procedure provided for Grace Huma below:
I examined Grace Huma and confirmed that she had varicose veins on her right leg, which are dilated and twisted veins that occur most often in the legs. Varicose veins may be caused by a familial link and pregnancy, obesity and a lack of exercise. Varicose veins are very common, but many people experience zero side effects of symptoms.
Blood Circulation and Veins
The blood is pumped, under pressure, from the heart through the arteries, which are robust and elastic-walled, and it is returned to the heart through the veins, which are weaker and thin-walled.
Primary Varicose Veins
The pressure of the blood returning to the heart from the legs and extremities is decreased as it pressed against gravity. Veins also have a series of valves that are there to prevent the blood from flowing backwards. But, individuals who are predisposed to varicose veins have weak vein walls that can stretch, and this causes the valves on either side of the vein walls to no longer meet. As a result, some of the blood in the vein may go backwards, and the pooled blood causes the vein to bulge and twist. This describes a primary varicose vein.
The pooling of blood may occur in one of two veins in the legs. The long saphenous vein that runs from the groin, down the thigh and calf and to the ankle and the short saphenous vein that branches off from the deep leg vein at the knee. The saphenous vein then runs down the back of the leg to the outer side of the ankle.
Varicose surgery is used to disconnect and remove the bulging vein, and this doesn’t cause circulation problems because there are other alternative channels that the veins will use to return the blood to the heart.
When the patient is comfortable and anaesthetized, I create a small incision of about 3cm in the groin. I extend this incision down and through the tissue until I locate the area at the top of the leg where the long saphenous vein meets the deep vein.
I then tie off the long saphenous vein using a nylon ligature just where the saphenous branches out from the deep leg vein, and I then remove the vein below the tie-off point. A PIN stripper is then fed down into that vein, which is a thin surgical steel rod that is approximately 50cm long and has a bent tip.
When the PIN stripper tip reaches the area of the vein just inside the knee, I press it through the vein, and this forces the skin upwards and forms a peak. A small incision is then made on the outside of the peak, and I gently push the PIN stripper through the incision.
Next, I return to the other end of the stripper and to the disconnected vein that has been created in the groin. The tail of the PIN stripper has a hole in it, which is similar to the eye of a needle. I first tie off the groin end of the vein using Vicryl, which is an absorbable thread. This thread is attached through the hole of the stripper, and I pull the head of the stripper through the incision in the knee. As a result, the vein is brought from the groin to knee. During this process, small branches of the vein are broken off, and this can create bleeding. Patients often experience bruising and some discomfort, as a result.
When the tail end of the stripper has been pulled through the knee incision, I tie the vein using an absorbable ligature, which prevents further bleeding. I then cut it and press it back through the incision in the knee.
This process treats the root of the problem, which is the long saphenous vein. Next, I address the bulging varicose veins. These may occur anywhere in the network of veins that branch off from the long saphenous vein that has become distended and twisted.
These veins are removed with stab avulsions. I make a 2-3mm incision (stab) through the skin using a scalpel. Then, using an instrument that is similar to a crochet hook, I hook the vein and pull it out, as I apply pressure to hinder bleeding. I often complete ten to 15 of these in one operation.
An absorbable stitch is used under the skin in the groin incision using a local anaesthetic. Small dressings are then placed over each of the stab sites, and the patient’s legs are tightly bandaged for 24 hours.
Patients must wear compression stockings for ten days after the surgery, which squeeze blood out of the legs and prevent swelling. Patients must wear the stockings day and night for the first few days.
While some exercise is encouraged, the legs must be kept raised while sitting. Significant bruising is typically experienced after a varicose vein operation.
Cost and Consultation
The operation costs vary and may be covered by medical insurance. An overnight hospital stay is not usually needed, it depends on the procedure performed. Each patient’s case is unique, and a personalised treatment plan will be created for you.
Contact Vein Solutions for a consultation with Mr Sameh Dimitri HERE, or please call us free on 0800 043 1997.
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