Endoscopic treatment

Endoscopic varicose vein treatment approaches the affected veins through a small incision, under the control of a miniature video camera. The problem veins are tied off (ligated), closed and completely removed from the leg, with direct visualisation of their interior throughout the operation. It is the suitable method for any type of varicose veins, but especially for large ones and for serious vascular diseases, such as venous ulcers.

Endoscopic treatment at a glance

• Type of procedure: vein removal under video control, through small incisions
• Anaesthesia: epidural, spinal or general, depending on the case
• Indications: varicose veins of any type, especially large ones; trophic disorders; venous ulcers
• Result: the branch of varicose veins is removed entirely
• Recovery: compression bandage for a few days; intense effort avoided for a few weeks

What is endoscopic varicose vein treatment?

Endoscopic treatment uses an endoscope — a thin optical device equipped with a small video camera — introduced through a small incision under the skin, into the area of the affected veins. The camera allows the visualisation of the interior of the problem veins and of all vascular abnormalities, so the veins can be tied off, closed and then removed with great accuracy, through small incisions. Through this technique, the branch of varicose veins can be eliminated entirely, in the same intervention.

Who is endoscopic treatment recommended for?

• patients with varicose veins of any type, but especially large ones
• cases with serious vascular diseases, such as venous ulcers
• patients in whom the varicose veins have caused significant trophic disorders — skin and tissue changes produced by poor blood supply
• people who could not improve their condition through preventive techniques or a balanced lifestyle and who want, for aesthetic reasons, another method than sclerotherapy or laser

A note for women who have recently given birth

Women who developed varicose veins during pregnancy are advised to consider this intervention only after at least 6 weeks from giving birth: veins formed in pregnancy can fade on their own, as the hormonal and circulatory balance returns to normal.

How does the procedure work, step by step?

1. Anaesthesia — epidural, spinal or general, established by the anaesthetist together with the surgeon, depending on the extent of the intervention.
2. Endoscope insertion — through a small incision, the special video camera is guided under the skin, up to the area to be treated.
3. Ligation and closure — under continuous visual control, the varicose vein is closed and separated from the adjacent tissues.
4. Removal — the vein is extracted through small incisions; the entire varicose branch can be removed completely.
5. The end — the incisions are closed and the compression bandage is applied.

What are the advantages of endoscopic treatment?

• can treat very serious cases of vascular disease — for example varicose ulcers
• removes the branch of varicose veins in its entirety
• the video camera gives the doctor high-precision, high-accuracy visualisation of the problem areas
• side effects and complications are very infrequent

What is the recovery like, day by day?

• First days: the compression bandage is worn for a few days, depending on the complexity of the case — its role is to prevent later bleeding. For any pain, the doctor may recommend common painkillers, such as paracetamol or ibuprofen.
• First weeks: intense physical effort, heavy lifting and prolonged standing are avoided. To prevent leg swelling and reduce pressure on the wounds, the legs are kept elevated (above hip level) while sitting.
• Full recovery: recovery time differs from patient to patient, depending on the severity of the case and whether one or both legs were treated. The doctor establishes at the follow-up when each activity can be resumed.

Risks and limitations

Being a true surgical intervention, endoscopic treatment involves regional or general anaesthesia and a longer recovery than the incision-free methods. Side effects and complications are nevertheless rare, precisely thanks to the continuous video control. The bruises, swelling and local sensitivity of the first days are normal and transient. The doctor discusses the concrete risks of your case before the operation.

Endoscopy compared with the other methods

• vs incision-free methods (STEAM, sclerotherapy, laser, the Alpha method) — these close the vein and leave it for the body to resorb; endoscopy physically removes it, under video control — preferable when the veins are very large or the disease is advanced
• vs cryotherapy — both remove the vein; endoscopy adds direct video visualisation, essential for extended varicose branches — see venous cryotherapy
• vs classic stripping — the same goals, but through small incisions and with video precision, so with rarer complications

Frequently asked questions

When is endoscopic treatment preferred?

When the veins are very large, when trophic disorders or venous ulcers exist, or when other methods have not worked. Direct removal under video control offers the safest result in these cases.

What anaesthesia is used?

Epidural, spinal or general — the decision is made together with the anaesthetist, depending on the extent of the intervention and the patient’s general condition.

How long does full recovery take?

From a few days to a few weeks, depending on the severity of the case and whether one or both legs were treated. The compression bandage is worn for a few days, and intense effort is avoided for a few weeks.

Are there less invasive alternatives?

Yes — for cases that do not require the direct removal of the veins: steam ablation, foam sclerotherapy or the Alpha method. See all varicose vein treatment methods.