Combined surgery for varicose veins
Cardiovascular Diseases / / August 12, 2017
angioplasty and heart
(method of operation)
The patient - on the back.
Anesthesia - endotracheal anesthesia;as an exception to use local infiltration anesthesia with 0.5% solution of novocaine.
Tools - general surgical suite, Vascular set of probes for extracting the saphenous veins with indexable caps.One day before the surgery scrub nurse must pass in sterilization at least three (in the case of operation on one leg) and at least six (in the case of operation at both the lower limbs) of elastic bandages.
processing the surgical field. finiteness treated from the groin to the tips of the toes.To the rear surface treatment nurse operating lifts limb of the heel region, and the surgeon treats the skin back surface.After the entire lower extremity skin twice lubrication scrub nurse gives the surgeon the sterile towel that tape up the stack to the level of both ankles, the free end of the towel fix hoe.By keeping the limb elevated, a table covered with a sterile sheet, on which
course of operations. first stage of the operation - ligation of the great saphenous vein at its confluence into the femoral vein (Troyanova operation).To do it, you need the following tools: bryushisty scalpel, sharp hooks, hemostats.After isolation from the surrounding tissue and the great saphenous vein ligation silk №3 all its collateral branches of the vein is ligated in place of its confluence with №4 silk stitching and a second silk №3 without suturing.
second stage - removal of the great saphenous vein in the thigh.To remove the great saphenous vein in the thigh sister gives the surgeon a special probe with a small olive tree, which is carried out in the distal end of the great saphenous vein to the internal femoral condyle.Over the olive make the skin incision with a scalpel.Below olive vein and peripheral cross section of its take on the clip.Oliva is withdrawn from the vein lumen and replaced it with a cutting head diameter of 0.8-1 cm. Vienna is tied to long thick rod with silk thread.The free end of the last stitch the end of the gauze pad length of 40-50 cm, which is in process of extraction of the probe together with the vein in a retrograde direction runs after them and plugging the channel formed in the subcutaneous tissue.To remove varicose veins in the leg make the skin incision above the venous trunk, in the subcutaneous tissue isolated varicose veins and excised with obligatory ligation of perforating veins.Operating wounds on the thigh and lower leg was sutured.Some isolated varices branches big and small saphenous veins for the purpose of obliteration is sewn and tied a ligature on the ball or stitch.