Embarrassing Illnesses

You'll be greeted by a member of the nursing staff before being asked to change into a theatre gown.

Your details will be checked by the nurse. The anaesthetist and surgeon will visit you and discuss what will happen and answer any worries or questions you may have. If you haven't already signed a consent form, you'll be asked to do so. 

The surgeon will confirm the exact procedure you're having and will mark the veins to be removed with an indelible felt tip pen. Make sure that all the veins you want removed are marked, as surgeons can sometimes miss the odd one, especially on a cold day when they aren't so visible. 

• If you're having a general anaesthetic, the ward nurse and a porter will take you to the anaesthetic room where your pulse, blood pressure and the amount of oxygen in your blood will be measured. The anaesthetist will insert a needle into the back of your hand and use this to give you drugs to send you to sleep.
• If the operation is to be carried out under epidural or spinal anaesthetic, the anaesthetist will insert a needle into your back. This will make the lower half of your body numb, but you'll remain awake during the operation.  
• If you're having a local anaesthetic, the surgeon will inject the anaesthetic into the area he will be operating on. This will sting a bit, but wears off as the area numbs. With a local anaesthetic, you're awake and will be able to feel touch and pressure, but you shouldn't be able to feel pain.

What happens during the operation?
The whole of your leg will be cleaned with iodine (brown stain) or chlorhexidine (pink stain) and sterile drapes will be positioned to create a clean operating field.

Surgery to the long saphenous vein
This is the vein which starts at the groin, runs underneath the skin of the thigh and calf and ends in the foot. 

During surgery, a two-inch cut is made in the groin and the junction between the long saphenous and femoral veins isolated. It's tied and divided. A 'stripper' (metal wire covered with plastic) is passed down the long saphenous vein to just below the knee. This allows the long saphenous vein to be removed from the thigh. Any veins that the surgeon marked before the operation are then pulled out (avulsed) through tiny cuts.

Surgery to the short saphenous vein
This is the vein that starts (at a variable point) behind the knee, and runs underneath the skin of the calf, ending in the foot.

During surgery, a one to two-inch cut is made at the back of the knee and the junction between the short saphenous and popliteal veins isolated. This is tied and divided. A stripper is passed down the short saphenous vein to the ankle. This allows the vein to be removed from the calf.

Will I need stitches?
The wounds are closed in different ways by different surgeons. Most use dissolving (absorbable) stitches under the skin for the groin incision, as these don't need to be removed, and sticky strips to close small phlebectomy wounds. Some surgeons, however, don't close or dress these smaller wounds at all. Others use fine stitches, which are removed a few days later.