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Traditional Redo High Tie, LSV strip and avulsions for Varicose veins (Recurrent Varicose Veins)
If you would like to see Mr Braithwaite as a Private Patient for Recurrent or other varicose vein treatment, please contact him at either the Park Hospital or Nottingham Nuffield.
What causes veins to come back so that they need to have redo high ligation? This operation is required when you have already had a cut in the groin for varicose veins but the veins have come back. ( Recurrent Varicose veins) In many people, the veins return because the long saphenous vein was not treated at the time of the first operation. New veins can grow out of the deep vein (common femoral vein) and reconnect to the long saphenous veins (neovascularisation - new vessels) In Some people, although they had a cut in the groin, the veins were not properly tied off. How is the operation done? The operation is normally done when you are asleep with a General Anaesthetic or under spinal or epidural anaesthetic (awake but numb from the waist downwards). The technique used by Mr Braithwaite involves a cut between 2 and 5cm long in the crease of the groin. This will be in the same place or close to the scar from your first operation. When you have had surgery before in the groin, there can be much scarring under the skin. This can make it difficult for a surgeon to identify the blood vessels and nerves in the groin area. There is therefore a risk of damage to nerves, lymphatics and blood vessels. It is for this reason that most surgeons recommend that redo operations are done by specialist vascular surgeons like Mr Braithwaite. Even with the expertise of a vascular surgeon, there can still be unavoidable damage. Rarely, people can have problems with wound healing and numb patches on the skin of the leg. The most serious problem that can occur is damage to the lymphatics. In some people this can result in a permanently swollen leg (lymphoedema) The varicose vein in the groin is tied off to prevent blood running in the wrong direction in the leg. The long saphenous vein (the main vein causing the varicose veins) is then removed using a special device - stripping the vein. Some techniques use an olive-like device that helps to strip the vein out. Mr Braithwaite thinks this method increases the chances of nerve damage. He uses a method that turns the vein inside out. The aim is to remove the vein without damaging the saphenous nerve. The stripped vein is usually removed through a 0.5cm cut around the knee area on the inside of the thigh or calf. The cut is made in one of the creases of the skin to minimise the effect of scarring. All the wounds are closed with a dissolving (absorbable) stitch that does not need to be removed. Local anaesthetic is put into the cuts so that there is very little pain when you wake up. After the vein has been removed, Mr Braithwaite then treats the lumpy veins in the calf and thigh by a treatment called vein avulsions. Are there any alternatives to Stripping? Apart from conventional surgery, 70% of varicose veins can be treated with techniques called VNUS, EVLT or Varicofoam Mr Braithwaite has completed research on recurrent varicose veins. He may recommend these newer techniques as they cause fewer complications than traditional redo surgery. Are there any risks to redo surgery? Yes. Apart from the risks of lymphoedema, there are the risks of traditional surgery. Please click here to see the risks of vein surgery If you would like to see Mr Braithwaite as a Private Patient, please contact him at either the Park Hospital or Nottingham Nuffield.
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