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• If your specialist has recommended that you have varicose vein surgery, this factsheet provides some standard information and advice about the procedure. However, you should always follow the instructions of your own specialist.

  If you have any unanswered questions or concerns, please do not hesitate to ask your specialist or nurse for more information. It is natural to feel anxious, but often knowing what to expect can help.

  What is varicose vein surgery?

  Varicose veins are swollen veins that look lumpy and bluish through the skin (usually on the legs). Varicose veins rarely cause medical problems but they can be unsightly. They do not tend to get better without treatment.

  Varicose vein surgery is routinely performed under a general anaesthetic as a day case, requiring no overnight stay in hospital.

  Preparing for your operation

  Your specialist or hospital will talk to you about admission procedure, however before you come into hospital for your surgery, you will be asked to:

  • have a bath or shower on the day of your admission
  • remove any rings, make-up or nail varnish and bulky or sharp jewellery. Rings and earrings that youd prefer not to remove can usually be covered with adhesive tape
  • follow any fasting instructions given to you. Typically, you  must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow a few sips of water until two hours beforehand

  When you arrive at the hospital, your nurse will explain how you will be cared for during your stay and will perform some simple tests such as checking your pulse and blood pressure, and testing your urine.  Your consultant and anaesthetist will also visit you. This is a good time to ask any outstanding questions about your treatment.

  Consent

  You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for to go ahead.

  Please refer to further information below regarding the possible side-effects and complications of this procedure. You need to know about these in order to give your informed consent.

  About the operation

  The procedure usually takes between one and two hours, depending on the exact of operation you are having and whether you have treatment on one or both legs.

  The most common operation involves a small cut in the groin at the top of the main vein affected.  This vein is tied (ligated), to stop blood flowing through it, and carefully pulled up (stripped) out of the leg through the incision.

  Sometimes the vein is tied off but not removed. Small cuts may be made along your legs to allow individual smaller veins to be removed. 

  The cut in the groin is usually sealed using dissolvable stitches and small leg cuts tend to be sealed with fabric strips. Your legs will be tightly bandaged.

  After surgery, blood can still flow up your legs because the deeper network of veins is left untouched.

  After your operation

  You will be taken from the operating theatre to a recovery room, where you will come round from the anaesthetic under close supervision.  After this, you will return to your room, where a nurse will make you comfortable. He or she will monitor your blood pressure and pulse at regular intervals and check the operation sites and blood circulation in your legs.

  You will need to rest on your bed until the effects of the anaesthetic have passed. Your legs may feel stiff and sore and you might not be able to get up straight away without help. Painkillers will be available to help relieve any discomfort.

  When you feel ready, you can begin to drink and eat, starting with clear fluids such as water or apple juice.

  Going home

  If your operation has been planned as a day case you will be able to go home once you have recovered from the anaesthetic. However, you will need to arrange for someone drive you home and then stay with you for the next 24 hours. If you stay overnight following your operation, you should be ready to leave the next morning.

  Before you leave, the nurse will advise you about caring for your wounds, and bathing. The nurse will also give you a contact telephone number for the hospital, in case you need to ask for any further advice.

  After you return home

  Here we cover some general information. Your specialist will also give advice thats specific to you. A general anaesthetic can temporarily affect your co-ordination and reasoning skills, so you should avoid driving, drinking alcohol, making any vital decisions or signing legal documents for 24 hours afterwards.

  Your recovery time will depend on whether you had one or both legs treated and the exact procedure used. Your legs are likely to be quite sore and stiff so be prepared to take it easy for several days. Dont do any strenuous exercise, lifting or carrying. If you need them, continue taking painkillers as advised by the hospital.

  You shouldnt drive until you confident that you could perform an emergency stop without discomfort – probably no less than week after your operation. Your specialist will advise you when can return to work.

  You will have bandages on your leg(s), which you should leave in place until your outpatient appointment (at least two or three days). These apply pressure to assist healing.   Its important that you do not stand for any length of time and ensure you elevate your legs when you are sitting (your feet should higher than your hips). This will prevent blood pooling in the leg and reduce the pressure on the healing scars.

  What are the risks?

  Removing varicose veins is generally safe surgical procedure. For most people, the benefits in terms of improved appearance are greater than the disadvantages. However, all surgery does carry some element of risk. This can be divided into the risk of side-effects and the risk of complications.

  Side-effects

  These are the unwanted, but usually mild and temporary, effects of a successful procedure. After surgery your legs will be sore and bruised and the wounds may bleed little. The bruising should ease within a couple of weeks. You may have small scars from the incisions but these will fade with time.

  Complications

  This is when problems occur during or after the operation. Most people are not affected. The main possible complications of any surgery are excessive bleeding, infection or an unexpected reaction to the anaesthetic. Complications may require further treatment such as returning to theatre to stop bleeding, or antibiotics to deal with an infection.

  Specific complications of varicose vein surgery are uncommon but can include damage to the nerves the skin, resulting in small numb patches on your legs. The feeling should return but this may take a few weeks or months.

  Its possible, though very rare, for the deeper major veins to be damaged. This may require further surgery and may worsen problems with blood flow in the veins. 

  Occasionally hard, tender lumps appear near the scars or along the line of the removed veins. These usually disappear after several weeks. Uncommonly, small patches of brown skin discolouration form where the veins were removed. 

  The chance of complications depends on the exact type of operation you are having and other factors such as your general health.   You should ask your surgeon to explain how these risks apply to you.

  This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

• Further information

  American Society for Dermatologic Surgery
  http://www.asds-net.org/FactSheets/spider_vericose_veins.html

  MayoClinic.com
  http://www.mayoclinic.com/invoke.cfm?id=DS00256
   

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