Home > Treatment Options > Ligation and Stripping

When surgery is aimed at treating deeper veins it requires a general anaesthetic in hospital with most patients returning home the same day as the procedure. The commonest procedure is to tie off where faulty valves connect between the surface and deep venous systems. The procedure to tie off the faulty vein is called a ligation. The length of the varicose vein is then removed which is called stripping.

When varicose veins originate from the groin (called the long saphenous vein) the surgery usually involves stripping of the long saphenous vein from groin to knee, after tieing off the faulty vein in the groin (saphenofemoral high ligation) and dividing all the varicose branches in the region. This stripping is usually done using the PIN (perforating invagination) stripper. This turns the vein inside out on its exit through a 3mm incision below the knee. Its advantage over older methods is minimal tissue trauma and a much reduced incidence of nerve damage.

When varicose veins originate from the back of the knee (called the short saphenous vein) surgery involves stripping of the short saphenous vein to mid calf and targeting associated varicose veins with stab avulsion.

Occasionally, perforating veins shown by ultrasound scanning are also ligated. The 3mm stab avulsion scars tend to become less visible after three months.

Procedures are usually carried out under a general anaesthetic in a day centre. Whilst surgical treatment of leg veins is still undertaken it has become less popular over the last 10 years. This has coincided with effective non-surgical methods becoming more established which do not require general anaesthetic or hospitalisation, no scarring from incisions and less side effects. There also has been more detailed information on long term results published. Clinical studies have shown poor long-term success after ligation and stripping procedures with significant recurrence rates and low patient satisfaction levels. Surgical stripping is now regarded as a last choice option rather than a first choice. In selected cases, however, it may still be the treatment of choice.