Short Saphenous Vein Ligation and avulsions for Varicose veins

If you would like to see Mr Braithwaite as a Private Patient for Short Saphenous or other varicose vein treatment, please contact him at either the 

Park Hospital or Nottingham Nuffield.

This operation is done when the valve in the vein behind your knee is faulty. People with a problem in the short saphenous vein frequently complain of aching in the calf after long periods of standing. In addition, there are usually varicose veins on the back of the calf, often running towards the outside of the ankle.

To reduce the amount of scarring and improve the results, Mr Braithwaite almost always insists that patients who have short saphenous vein surgery have a special scan. This scan called a Duplex scan, allows Mr Braithwaite to identify the site of the problem and plan the surgery appropriately. Some surgeons still do the operation without a preoperative scan. 

Mr Braithwaite has been involved in research about the technique.

What happens when I have short saphenous vein surgery?

This is probably the second most frequently performed varicose vein operation done in the NHS. Until the introduction of new techniques, this is the way that most patients have had their varicose veins treated.

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 3cm long in the crease of the knee or back of the thigh. This leaves an almost invisible scar in the crease behind your knee. 

The varicose vein in the knee (short saphenous vein) is tied off to prevent blood running in the wrong direction in the leg. The short 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 sural nerve. 

If this nerve is damaged, a rare complication, then you would have a numb area on the outside of your foot. In time, the feeling comes back but it is not always as good as before. You are still able to walk and function as normal but need to take care that the numb area does not get damaged as you will not feel any pain in that place.

The stripped vein is usually removed through a 0.5cm cut around the lower 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, many short saphenous veins can be treated with Varicofoam. Mr Braithwaite has been able to successfully treat the short saphenous veins of patients with varicofoam whilst they are taking Warfarin

Are there any risks to vein surgery?

Yes. 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.