Ambulatory Surgery varices

In the legs, there is a double venous system: the deep, which carries the bone of the circulation, and the superficial, which constitute the internal saphenous and external saphenous with its branches. Varicose veins are produced in the superficial venous system.

The human being when standing, has to fight against the law of terrestrial gravity, which tends to make the blood go to the foot, instead of the heart. To avoid this, we have sigmoid valves that are at different heights along the venous system, to fragment the weight of the blood circulation, and force, to flow upwards, to the heart.

Initially it is a benign disease that gives little symptomatology. Over the years, the varicose veins grow and the clinic of venous insufficiency appears. We measure this clinic according to the CEAP scale, which combines the Clinic, the Anatomical Extension and the Physio-Pathology on a scale of one to six.

In the initial phases, there are telangiectasias, varicose veins and uncomplicated varicose veins, which have a mainly aesthetic interest. Afterwards, edema and skin trophic disorders appear, reaching the final stages five and six, to varicose ulcers.. In addition, episodes of thrombophlebitis and varicorrhagia can occur, which are hemorrhages due to rupture of the vein, through the skin.

It consists of ligating the silence of the saphenous veins and their branches, through a small incision in the inguinal fold, saphenous rupture is not performed and if a phlebotomy or removal of the varicose branches is performed with the help of a small hook. Cutaneous incisions are minimal, there is hardly any surgical trauma and they do not require stitches in the skin.

We have recently modified the technique by introducing the micro-foam, mixing the liquid of ethoxysclerol with gases, such as ambient air or CO2 forming a small whitish foam.. This foam is injected into the varicose veins and its small micro-spheres spread along the varicose veins, producing a vasospasm and the occlusion of all the varicose veins.. In the consultation we use the etoxisclerol foam in isolation for the treatment of small or moderate varicose veins, and for spider veins.

In this way, surgical aggression that usually consists of one or two small incisions is minimized. The patient returns home the same day of the intervention, requires some elastic restraint consisting of an elastic bandage, or an elastic stocking to prevent edema of the limb, the next day you can walk with minimal discomfort without precise postures or rest, beyond normal. Depending on the extent of the varicose veins, a one-week sick leave will be required, but in many cases it is not necessary. There are no cutaneous stitches to be removed. It is necessary to continue with an elastic stocking for a few weeks to avoid the appearance of edema. It is also not necessary to use low molecular weight heparins or other medications, except for some analgesic sporadically.