Having surgery for varicose veins

This page explains more about having surgery to treat varicose veins. 

Surgery

You can have surgery to remove the vein causing the problem. It is performed under general anaesthetic so that you are asleep. This surgery is carried out less frequently than the RFA and UGFS procedures. The operation varies from person to person, depending on where the faulty valves are and the size of your veins.

For the vein stripping procedure, you will have a cut about 4 to 6cm long running in the skin crease of the groin. Through this cut, the top end of the leaky vein (known as the great saphenous vein) is tied off to stop blood flowing through it (this is known as ligation). A wire is inserted into the vein and passed down to knee level. Then, a second cut is made around the knee and the vein is pulled out.

Less frequently, when the main vein on the back of the knee (short saphenous vein) has a leaking valve, it also needs ligation. A cut about 3cm long will be made on the back of the knee. The vein is then removed as before. The short saphenous vein is rarely stripped from the leg because it is close to a nerve, which may be damaged.

Finally, in most cases, the visible varicose veins are removed from the leg through tiny cuts (2 to 3mm). This procedure is called avulsion. There may be a large number of tiny cuts if there are many varicose veins.

The leg is bandaged firmly from toe to groin at the end of the operation.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you understand what it involves and agree to have the treatment.

You can read more about our consent process.

Risks and possible complications after surgery

As with any surgery, there is a risk of you having a medical complication. Your doctor will go through all the risks with you before you sign your consent form.

The more common surgical risks include:

Common problems

• Most people feel a tightening along their leg after the procedure.
• Once the anaesthetic wears off, there may be some pain and bruising along the line of the treated vein. The bruising will disappear after a few weeks.
• About 1 in 10 patients develop swelling (inflammation) causing discomfort and lumpiness around the vein (this is called phlebitis). This usually settles down without treatment, but anti-inflammatory painkillers may help. It may also leave some brown staining on your skin when the swelling has reduced. This staining fades over time, but it can also be permanent. To minimise the chances of phlebitis, it is important that the vein is squeezed empty after the procedure. For this reason, you will need to wear compression stockings.
• Varicose veins can come back after all types of procedures. The underlying weakness in the vein valves may result in other veins causing further varicose veins in the future, even when all previous veins have been treated correctly.

Rare problems

• Deep vein thrombosis (DVT) is a rare complication of any operation to the legs. DVT is a blood clot that develops within a deep vein in the body, usually in the leg. To lower the risk of developing DVT, you will be advised to return to walking normally after your treatment. Walking keeps your blood flowing in the important deep veins, whereas being inactive can increase your risk of DVT.
• There is a small risk of damage to other veins and nerves, which may result in numb patches of skin or tingling. This normally diminishes with time.

Having surgery (vein stripping or multiple avulsions) potential has additional complications. Your doctor will discuss this with you.

Bleeding 

Sometimes a little blood oozes from the wound sites during the first 12 to 24 hours. This usually stops on its own. If necessary, press on the wound for 10 minutes. If bleeding continues after doing this twice, contact your GP or the hospital.

Wound infection 

Wounds sometimes get infected and this may need to be treated with antibiotics. This is not very common and bad infections are rare. Occasionally, hard and tender lumps appear near the operation scars or along the line of the removed veins. These can even appear some weeks after the operation, and are not a cause for concern. However, if they are accompanied by excess swelling, redness and severe pain, they may represent a wound infection and you should see your GP regarding this.

Chest infection 

This can occur following surgery under general anaesthetic, particularly in smokers, and may require treatment with antibiotics and physiotherapy.

Leaving hospital after surgery

It is not usually necessary for you to stay overnight and you can to leave hospital on the same day.

You will need someone to help you get home and to stay with you for at least 24 hours after your surgery.

It is important that you rest for the remainder of the day to recover from the anaesthetic. You are unlikely to be sick and should be able to eat and drink again within a few hours.

Most people describe the feeling in their leg as stinging or burning when they wake up from the operation. It is unusual for the leg to be painful. Discomfort in the leg usually resolves around 2 weeks after the operation.

Bleeding and bruising

Some of the cuts may bleed a little over the first 24 to 48 hours. It is best to keep your leg covered with bandages for the first 48 hours. The bruising will last for 3 to 4 weeks. The cuts, although initially visible, will become virtually invisible within 9 to 12 months.

Bandages

The bandages need to be removed after 48 hours and replaced with T.E.D.™ stockings. You will be given a T.E.D. stocking by the nurse looking after you in the recovery area after your operation. Wear the T.E.D stocking only during the day for a further 12 days. You do not need to wear it at night.

Bath or shower

You can have a bath or shower 48 hours after your surgery. You can then remove the adhesive strips placed on the incisions during the surgery. You should remove your stocking before entering the bath or shower.

Walking

It is a natural reaction to limp when your leg is painful. Your muscles, bones and joints are not affected by varicose veins treatment, so you need to walk as normally as possible. Walking keeps your blood flowing in the important deep veins. Being inactive can increase your risk of DVT.

As a minimum, we recommend 20 minute walks, 3 times a day, every day after your procedure.

Regular daily exercise, such as walking or using an exercise bike, and wearing your stockings for a few more days may help with the pain and bruising.