Varicose vein surgery with an intravascular laser under expansion

Preparation:

  • Fast: Do not drink fluids or solid food 6 hours before the operation.
  • Painkillers: 1 hour before the operation , take the painkillers Panodil, Paracetamol or Paratabs 500 mg. If you weigh less than 70 kg then 2 tablets and otherwise 3 tablets. 
  • Shower the night before surgery before bed and also on the morning of surgery. Wash with plain soap. Do not cream or emollients on the skin on the day of surgery. Do not wear tight pants during the procedure due to bandages/elastic socks worn after the operation.
  • It is preferable to avoid the use of anticoagulants such as magnyl, codeimagnyl, cardiac magnyl, etc.) and nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g. Ibufen, Ibumetin, Naprox, Voltaren, Vostar....) 4-5 days prior to surgery. If you are taking Warfarin (Covar/Dicumarol), Xarelto, Pradaxa, Eliquis or similar anticoagulants you will receive special instructions. The same goes for medications; Grepid, Clopidrogel and Plavix which are anticoagulants. Patients taking antihypertensive and/or cardiac medicinal products are advised to take them on the morning of surgery with a sip of water. The use of a contraceptive or menopausal pill does not need to be stopped. People with diabetes who are using insulin need to talk to their anaesthetist a few days before the operation (tel. 590 9213).
  • The operating theatre has small and locked compartments for valuables/telephones etc. Skurðstofan ehf does not guarantee any loss or possible damage to personal effects. The use of smartphones during recovery is prohibited. All recording/distribution of audio and video from the operating theatre as well.
  • Upon arrival at the operating theatre, you will meet with a surgeon and anesthesiologist as well as operating room staff. You'll get a robe to put on and disposable underwear. Draw on your feet and resound. All patients must sign informed consent prior to the procedure.
  • If you have known allergies to medicines, plasters, disinfectants, etc. it must appear before the operation.
  • The Icelandic Health Insurance (SÍ) pays for the operation mostly for those with health insurance in Iceland. Payment is collected for the operation. You can pay by credit card or credit card, but not by bill. 
  • After the operation: The operation is performed in expansion. This is a special method of tumescent stunning by using a fine needle the area of operation is attenuated with cooled anaesthesia. All patients experience are stinging and feeling of pressure. Then you go in with a holster in the vein. Through that is a disposable laser conductor. This conductor heats the inside of the blood vessels to >100°C and closes it. In addition, smaller branches from the stem veins are removed through needle piercings. The procedures are performed with intravenous anesthetics similar to gastroscopy. After surgery, you will be able to recover from recovery for 1/2-1 hour or until you are fit to travel. Patients are considered unfit until the following day. It is advisable that patients do not stay alone first after returning home. Pain: During the first few days, you can expect minor discomfort in the surgery area. It is advisable to use painkillers if needed and are available without a prescription at pharmacies (Paratabs/Panodil 500 mg, 2 tbl up to four times/day) or Parkodine with a prescription. Packaging: During the operation, the foot is placed in an elastic sock. On the outside there is an elastic bandage that can be removed after 48 hours and discarded. You can also remove the elastic sock and take a shower, then put it back on. Bandages under the elastic stocking can be removed simultaneously before the shower and discarded. The sock should then be used for 5-7 days after surgery. Day and night. The sock reduces pain, bruising and prevents swelling from accumulating. Itching may accompany prolonged use of the dressing. Some people benefit from taking common allergy medications available without a prescription to relieve the itching. It is then recommended that patients purchase the correct size pharmacy "flight socks" that extend up to the knee and use from day 5-7 after surgery during daytime for 1-3 weeks thereafter.  Movement: Generally slow down for the first 1-2 days after surgery. But take regular walks and do foot exercises by moving up and down around the ankle joint; "pumping exercises". This prevents swelling in the leg from accumulating and reduces pain. Swimming and gymnastics after 10 days or when puncture wounds are completely closed or healed. Complications: Bruising of the skin at the injection site is normal. Also, a lump/cord forms under the skin first where the varicose veins were. Hirudoid cream may be used after 5-7 days available without a prescription to reduce bruising. It is applied thinly to bruised areas 2-3 per day until the bruising disappears. Bleeding and infections may occur. In an infection there is abnormally severe pain in the wounds and possibly fever. In case of bleeding or suspected infection, contact your doctor. Occasionally, there may be prolonged staining and loss of sensation/loss of skin. Blood clots after surgery have been described but are very rare. At the end of the procedure, everyone receives a blood-thinning injection as a preventive measure. Dressings can cause intolerance or, at worst, blistering. In such cases, it is advisable to remove them or change their location. 
  • After-treatment: Frequently, later (>3 months after surgery) are injected into smaller varicose veins and hernia of blood vessels. The medicine polidocanol (Aetoxysclerol) is used alone or as a foam. The medicine blocks these blood vessels. The long-term benefit of this treatment is individual, but never complete, and frequently the injection procedure needs to be repeated. 
  • Results: The long-term success of the procedure depends, among other things, on the extent and nature of the disease and careful preoperative evaluation and ultrasound. Attempts are made to perform a permanent procedure, but it should be borne in mind that this is a chronic disease and that its root cause is poorly known, and therefore it can never be excluded that varicose veins may re-develop or in other places over time. Recurrence of varicose veins after the best possible treatment is common in the long run. 
  • Work: Absences from work are individual, depending on the scope of each person's activity and work. It is not unusual to be off work for a few days after the operation and longer in exceptional circumstances. You may commence work when you so wish without compromising the effectiveness of the operation. Certificates for work are issued upon re-entry.

Stefán E. Matthíasson dr. med.
Diagnosis and treatment of surgical and vascular diseases