Varicose Vein Surgery
Varicose Vein Surgery treats symptomatic varicose veins by removing or ablating the incompetent superficial venous system — relieving aching, swelling, and skin changes while preventing progressive venous ulceration, using open surgical stripping or modern minimally invasive endovenous techniques.
Overview
Varicose Vein Surgery addresses the refluxing superficial venous system responsible for symptomatic varicose veins by either surgically stripping the great or small saphenous vein or ablating it using endovenous laser or radiofrequency energy, combined with multiple stab phlebectomies to remove the visible varicose tributaries. Modern endovenous techniques have largely replaced traditional open surgical stripping in centres with the appropriate equipment, offering equivalent long-term outcomes with reduced haematoma, nerve injury risk, and recovery time. Treating varicose veins before they produce skin changes — lipodermatosclerosis and venous ulcers — prevents the more complex and resistant chronic wound management challenges of advanced venous disease.
Types of Varicose Vein Treatment
Varicose vein treatment encompasses both surgical and minimally invasive options based on vein anatomy, reflux pattern, and patient preference.
- Endovenous Laser Ablation (EVLA — laser fibre inside the vein with tumescent anaesthesia)
- Radiofrequency Ablation (VNUS ClosureFast — thermal catheter ablation)
- Surgical Saphenofemoral Junction Ligation and Stripping (traditional open approach)
- Ultrasound-Guided Foam Sclerotherapy (chemical ablation — for small residual varicosities)
- Stab Avulsion Phlebectomy (multiple small hook-based tributary removal — usually combined)
Risk Factors for Varicose Vein Disease
Varicose veins develop from a combination of inherited venous valve weakness and acquired factors that increase venous pressure.
- Family history — 80% of varicose vein patients have an affected first-degree relative
- Female sex and pregnancy — pregnancy increases saphenous vein reflux significantly
- Prolonged standing occupations — nurses, teachers, retail workers, hair stylists
- Obesity increasing intra-abdominal pressure and venous reflux severity
- Age — valve incompetence worsens progressively with age
- Previous DVT causing post-thrombotic venous incompetence
Varicose Vein Symptoms
These symptoms indicate clinically significant varicose vein disease requiring vascular assessment with duplex ultrasound and consideration of treatment.
- Visible ropey, dilated, tortuous veins in the legs
- Aching, heaviness, and fatigue in the legs worsening throughout the day
- Ankle swelling worsening in warm weather and after prolonged standing
- Itching over the varicose veins or around the ankle — lipodermatosclerosis
- Night cramps and restless legs associated with venous insufficiency
- Skin discolouration and haemosiderin staining around the ankle
- Eczema and skin thickening over the medial ankle
- Healed or active venous ulcer indicating advanced chronic venous insufficiency
Key Benefits
Discover the advantages of choosing our varicose vein surgery services.
EVLA achieves equivalent varicose vein ablation to open stripping with faster recovery
Tiny micro-wounds from phlebectomy heal with invisible or barely perceptible scarring
Same-day procedure with immediate ambulation and return to light activities within 2 to 3 days
Treats the underlying venous reflux preventing the recurrence that sclerotherapy alone cannot guarantee
Compression stocking compliance after treatment is the single most important factor for optimal outcome
Clinical Features
The technology, techniques and clinical approach behind our varicose vein surgery.
Duplex venous mapping confirms all sites of incompetence before planning any treatment
Tumescent infiltration under ultrasound guidance protects skin and nerves during laser energy delivery
Laser fibre positioned 2 cm from saphenofemoral junction protects the deep vein from thermal injury
Stab phlebectomy micro-wounds achieve excellent cosmetic results while removing all varicosities
Compression stockings applied before discharge and maintained for the full prescribed 2 to 6 weeks
Preparation Instructions
After Varicose Vein Surgery, wear the prescribed compression stockings consistently for 2 to 6 weeks — compression is the single most important post-operative measure for reducing haematoma, bruising, and recurrence risk. Walk for at least 30 minutes every day starting from the day of surgery — walking is strongly encouraged and promotes healing. Avoid prolonged standing still, long-haul flights, and hot baths for 4 weeks. Attend duplex follow-up at 6 weeks to confirm ablation success. Contact your vascular surgery team for sudden calf swelling, redness, or breathlessness suggesting DVT after discharge.
The Procedure
Step-by-step guide to what you can expect during your varicose vein surgery procedure.
Pre-Operative Duplex Venous Mapping
Your vascular surgeon reviews the duplex venous map — confirming the site and severity of saphenofemoral or saphenopopliteal junction incompetence, identifying all incompetent truncal and tributary veins, and planning the most complete and durable treatment for your specific venous anatomy.
General Anaesthesia and Tumescent Infiltration
General anaesthesia is administered for the endovenous or combined procedure. For EVLA, tumescent anaesthetic solution is infiltrated along the entire length of the great saphenous vein under ultrasound guidance — compressing the vein around the laser fibre and providing post-procedure analgesia.
Endovenous Laser Fibre Placement
Under duplex ultrasound guidance, a laser fibre is advanced through an access sheath to the saphenofemoral junction — positioned 2 cm below the junction to protect the deep vein confluence — before tumescent infiltration and laser treatment begins.
Laser Ablation of the Saphenous Trunk
The laser is activated and the fibre is slowly withdrawn at 1 to 2 mm per second — delivering precise thermal energy to the vein wall causing permanent fibrosis and occlusion of the incompetent saphenous trunk while surrounding tumescent fluid protects skin and nerves.
Stab Avulsion Phlebectomies
Multiple 2 to 3 mm stab incisions are made over the marked tributary varicosities and a fine phlebectomy hook is used to deliver and avulse each tributary vein. This methodical process removes all visible varicose tributaries through invisible micro-wounds.
Compression Dressings and Discharge
Compression dressings are applied immediately and you are fitted with class II compression stockings before discharge. Ambulation begins immediately and is strongly encouraged. You go home the same day with written instructions on walking, stockings, and warning signs.
What to Expect
Varicose Vein Surgery is performed under general anaesthesia and takes 60 to 90 minutes. For endovenous techniques, a laser or radiofrequency catheter is positioned in the saphenous vein under ultrasound guidance and tumescent anaesthesia is injected around the vein before thermal ablation. Stab phlebectomies through 2 to 3 mm micro-incisions remove the visible tributaries. Compression bandages are applied and you are discharged the same day.
Frequently Asked Questions
Common questions about varicose vein surgery.
Related Services
Explore other services in our Vascular Surgery department.
Thrombectomy Bypass
AV Fistula
Carotid Endarterectomy
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