What Is Endoscopic (Closed) Saphenous Vein Removal? What Are Its Advantages?
One of the most common conditions in the field of heart and vascular diseases is venous insufficiency and the resulting formation of varicose veins. Varicose veins occur in the veins, that is, the large blood vessels called superficial veins, which are generally visible through the skin. Varicose veins can form when a vein is unable to function adequately. This problem is usually seen in the saphenous veins, which run from the legs down to the ankle and carry blood over a large area. Especially these veins seen along the inner and outer sides of the lower leg can become more prominent with color changes and swelling when varicose veins form. Surgical options for the treatment of varicose veins, which are commonly encountered in the community, can sometimes be the only option. For such problems, which seriously affect the patient's quality of life, the possibilities offered by developing technology are used by physicians. Endoscopic surgical treatments are among them. Endoscopic saphenous vein removal is a practical method that provides comfort to the patient, is easy to perform, and offers an alternative to a long recovery process.
For varicose veins and other heart and vascular diseases, you can make an appointment to be examined and receive the correct treatment, or visit our clinic.
What Is Endoscopic (Closed) Saphenous Vein Removal?
Endoscopic saphenous vein removal may not be applied to every patient. To understand this surgical procedure, it may be necessary to know the functions of the saphenous veins in the body and the region they are located in, and how and under what conditions this endoscopic surgery is performed on the patient. In this way, the patient can choose the right physician and clinic when applying for this treatment.
Veins are the group of blood vessels that carry low-oxygen blood back to the heart. Low-oxygen blood traveling to the heart passes through the lungs, where its oxygen level is raised. In a properly functioning circulatory system, the veins must collect blood from all extremities and organs in order to return it to the heart. Therefore, there must be a backflow mechanism in the blood ascending from the legs. In other words, blood reaching the heart from below upward creates a flow opposing gravity. Many factors enable this reverse mechanism. However, the valves in the veins, venous pressure, the muscles that support venous pressure, and lymphatic drainage are the most important factors supporting this flow. Impairment of venous mechanics occurs especially in the large veins of the legs and can lead to a venous insufficiency condition. The saphenous veins are the veins where large varicose veins are most commonly seen. Starting from the groin and reaching the inner side of the knee, the saphenous vein continues from there to the back of the knee and the calf. Continuing the circulation down to the ankle, and branching after the ankle down to the toes, it forms an important vascular network for blood circulation in the leg. Insufficiency occurring in the saphenous veins can be a precursor to serious vascular diseases, especially varicose veins.
Treatment options for venous insufficiency are quite varied. In these patients, the priority is to treat the vein in place with intravascular interventions without removing it from the body. However, in some patients, the saphenous veins may need to be removed for insufficiency or for different operations such as bypass. Instead of the surgery in which an incision is made from the groin to the knee to remove the saphenous vein, as in older surgical techniques, endoscopic (closed) surgical methods are used. Endoscopic saphenous vein removal is a treatment that offers many advantages for patients. It is most appropriate for this surgery to be performed by an experienced cardiac and vascular surgeon and for the patient to be followed by an experienced physician throughout the entire recovery process.
In Which Operations Is Endoscopic Saphenous Vein Removal Preferred?
Venous insufficiency can be a precursor to many diseases or can arise from different diseases. Therefore, in the presence of venous insufficiency, after a detailed history is taken, the examination and appropriate testing must be performed to identify the cause of the problem. With the possibilities offered by developing medical methods, before proceeding to the surgical option in the treatment of venous insufficiency, the patient's condition is evaluated and different treatment approaches are sought. The first treatment to be applied when the saphenous veins in the legs lose their function may not always be endoscopic removal of the vein. In particular, minimally invasive procedures targeting the inside of the vein, such as sclerotherapy, laser ablation, foam treatment, and radiofrequency ablation used in varicose vein treatment, are considered. In such procedures, the goal is to destroy or treat the function of the saphenous vein in place without removing it from the body. That is, it is closed off so that blood flow no longer passes through the vein, or in veins that have lost their function, blockages can be relieved by intravenous medication. Which of these treatments, which vary according to the patient profile, is most suitable is determined under physician supervision. The reason for considering these options in the first stage is to rule out alternatives before subjecting the patient to a surgical procedure. In advanced venous insufficiency conditions where these treatments are not sufficient, the saphenous veins may be removed. Saphenous vein removal is generally preferred in the following situations:
Risk of coronary artery disease due to venous insufficiency
Risk of intravascular clots (thromboembolism) due to loss of vessel function
Presence of large-diameter varicose veins in the leg
Severe cellulitis with effects on blood and lymph circulation
Use of the saphenous vein in bypass surgery
Completely restricting the function of insufficient saphenous veins or completely removing them from the body is sometimes the only option. This is because this condition causes the heart to expend more effort to pump blood and creates a risk for coronary diseases. Heart and vascular diseases, arising from seemingly simple causes and progressing over the years, lead to problems that seriously affect the patient's life. Detecting diseases before they develop through regular checks and follow-up can be done with the perspective of an expert physician. If you suspect or have a circulatory problem, you can make an appointment and be examined by our experienced physicians without waiting for it to progress.
How Is Endoscopic Saphenous Vein Removal Performed?
The magnitude of the load that the saphenous veins bear in blood circulation in the legs can be considered in direct proportion to the area they cover. The saphenous vein and the veins branching from it form a long vascular network that extends from the groin down to the ankle. For this reason, a disease developing in these veins can progress insidiously depending on many factors. There can be different causes affecting the saphenous vein insufficiency condition. The factors commonly found in the histories of patients who present with complaints related especially to venous insufficiency in the legs can be listed as follows:
Smoking and tobacco use, or having used them for many years
Obesity
Inadequate and unbalanced nutrition
Sedentary lifestyle
Working in a job that requires sitting for long periods or standing still
History of multiple pregnancies
Advanced age
Venous insufficiency can occur in patients who have several of the above characteristics. When the saphenous vein in the legs loses its function, the veins become visible through the skin. Veins with insufficiency may be blue-purple in color, noticeably bulging, and itchy. These veins may sometimes cause bursting of vessels that cover a red surface visible through the skin due to scratching or trauma. In addition, saphenous vein insufficiency can also lead to an increase in cellulitis in the legs. Among the reasons patients consult a doctor for saphenous vein removal, cosmetic concerns may also be present alongside the pathologies. Recently, the possibility of performing operations without leaving extensive scars offers techniques that reduce patients' cosmetic concerns.
In the saphenous vein removal procedure, endoscopic surgery is used instead of the classic technique performed in older surgical methods. In the classic saphenous vein graft method, a long and deep incision is made from the groin to the knee to remove the vein. Instead of making an incision along the entire length of the vein, some methods create a tunnel in the leg, and surgical incisions over a shorter area may also be used in the operation. Endoscopic surgery, which offers an alternative to deep scarring and the recovery period of the classic and tunnel methods, is more beneficial. In endoscopic saphenous vein removal, instead of a deep and long incision, closed surgery is performed through an area of a few centimeters opened in the leg. The operative field can be viewed through this opening with a small camera, and the procedure can be completed, and the small opening is easily closed with a few sutures. The endoscopic saphenous vein graft procedure is a system frequently used in coronary bypass surgery and in varicose vein treatment. A vein that has not been damaged and has not lost its function can be practically removed with this method and used in bypass surgery. Varicose veins that need to be removed are also taken out with the same method, completing the patient's varicose vein treatment.
What Are the Advantages of Endoscopic Saphenous Vein Removal?
In saphenous vein operations performed with the classic and tunnel methods, significant differences arise compared to endoscopic operations. Preferring closed surgery is advantageous both because patients spend a shorter time returning to social life and because of its ease of application for the physician. In addition, with this method, both the procedure and postoperative patient care are reduced, providing a cost advantage. In the classic saphenous vein operation, a surgical incision is made in the leg in the shortest possible way, from the groin to just above the knee. In this wound area, infection, lymphangitis, edema, cellulitis, and fat necrosis are among the most common postoperative complications. Especially in patients with chronic conditions such as diabetes or hypertension, those using additional medications, and those with low wound tolerance, the open surgical method may be a disadvantage. In patients who undergo closed surgery, the sensory functions in the operative area recover within a short time, although the loss of function is not as pronounced as with open surgery. According to studies in these patients, the level of pain and return to social life after surgery is nearly nonexistent after the first 2-3 days.
If you suspect heart and vascular diseases, being examined promptly by an experienced physician at a successful clinic is the most appropriate step for early diagnosis of the disease. You can schedule a free appointment immediately for innovative medical methods offered by closed surgical techniques and for the expertise of specialist physicians.
