Name of the Procedure:

Ligation, Division, and Stripping of the Short Saphenous Vein

Summary

This procedure involves tying off (ligation), cutting (division), and removing (stripping) the short saphenous vein. It's commonly performed to treat varicose veins and other venous insufficiencies in the legs.

Purpose

This procedure is primarily used to address varicose veins, which are swollen, twisted veins that can cause pain, swelling, and cosmetic concerns. The goal is to improve blood flow, reduce symptoms, and prevent complications like skin ulcers.

Indications

• Persistent pain, swelling, or discomfort in the legs.
• Visible varicose veins.
• Venous insufficiency leading to skin changes or ulceration.
• Failure of conservative treatments (compression stockings, lifestyle changes).

Preparation

• The patient may need to fast for several hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted.
• Pre-operative ultrasound to map the veins.
• Arrangements for someone to drive the patient home post-procedure.

Procedure Description

1. The patient is given local or general anesthesia.
2. An incision is made near the knee to access the short saphenous vein.
3. The vein is tied off (ligated) at its end points to prevent blood flow.
4. The vein is then divided, and a special tool is used to strip the vein out through the incision.
5. Additional steps may be taken to address any branch veins.
6. The incisions are closed with stitches or surgical glue, and a compression bandage is applied.

Duration

Approximately 1 to 2 hours.

Setting

Usually performed in a hospital or an outpatient surgical center.

Personnel

• Vascular surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a vascular ultrasound technician

Risks and Complications

• Infection at the incision sites.
• Bleeding or bruising.
• Nerve damage causing numbness or tingling.
• Blood clots.
• Deep vein thrombosis (rare).
• Recurrence of varicose veins.

Benefits

• Reduced pain and swelling.
• Improved cosmetic appearance of the legs.
• Prevention of further venous complications.
• Benefits are typically noticed within weeks to months post-procedure.

Recovery

• Wear compression stockings as directed.
• Keep the leg elevated to reduce swelling.
• Limit physical activity as recommended.
• Follow-up appointments to monitor healing.
• Most patients can resume normal activities within a week, but full recovery may take several weeks.

Alternatives

• Sclerotherapy: injecting a solution to close the vein.
• Endovenous Laser Therapy (EVLT): using laser energy to close the vein.
• Radiofrequency Ablation (RFA): using radiofrequency energy to close the vein.
• Pros: Less invasive, shorter recovery time.
• Cons: May not be suitable for all types of varicose veins or severe cases.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel any pain. Afterward, they may experience soreness, bruising, and swelling, which can be managed with pain medications and compression stockings. Follow-up care is crucial to ensure proper healing and optimal results.