Preoperative preparation for endovenous laser ablation surgery for varicose veins may involve the following steps:

• A review of your medical history and a physical examination to check for any medical issues that need to be addressed prior to surgery.
• Depending on your medical history, social history, and age, you may need to undergo tests such as bloodwork and imaging to screen for any abnormalities that could compromise the safety of the procedure.
• You will be asked if you have allergies to medications, anesthesia, or latex.
• You should inform your doctor of any medications or supplements you are taking or any medical conditions you have such as heart or lung disease.
• You may be asked to refrain from certain medications such as blood thinners or aspirin or vitamin/herbal supplements for a week or two prior to the procedure.
• You should refrain from alcohol or tobacco at least a few days before treatment and several weeks after, as it can hinder the healing process.
• You should not consume solids or liquids at least 8 hours prior to the procedure.
• Written consent will be obtained from you after the procedure has been explained in detail.

Endovenous laser ablation procedure usually takes less than an hour and you may go home the same day. Generally, endovenous laser ablation for varicose veins will involve the following process:

• You will lie down on the procedure table in a face-down or face-up position depending upon which veins are being treated.
• An imaging technique, such as ultrasound, is utilized to guide the procedure.
• The leg to be treated is administered with numbing medicine to reduce any discomfort and keep you comfortable.
• Once the skin is numb, a needle is used to make a small puncture hole on the vein to be treated.
• A catheter (thin tube) consisting of the laser heat source/laser fiber is placed into the affected vein.
• Additional numbing medicine may be administered around the vein prior to ablating (destroying) the varicose veins.
• Once the catheter is confirmed to be in the correct position, the laser fiber at the end of the catheter is fired up to heat up the entire length of the vein and seal it closed. This results in the stopping of blood flow through the vein.
• The problem vein eventually shrinks and fades away, eliminating vein bulging at its source and resumption of efficient blood circulation through other healthy veins.
• The catheter and laser are removed and the puncture hole is covered with a small dressing.

In general, postoperative care instructions and recovery after endovenous laser ablation for varicose veins will involve the following steps:

• You may experience pain, inflammation, and discomfort in the treated area. Medications are prescribed as needed to manage these.
• Instructions on bathing and incision site care will be given to keep the incision site clean and dry.
• Application of ice packs over the treated area is also recommended for 10 minutes at a time for few days to control bruising, swelling, or pain.
• You are advised to wear compression stockings for a few days to weeks as it can help prevent blood pooling or clotting, as well as leg swelling.
• You are encouraged to walk 10 to 20 minutes about 3 times a day for a couple of weeks, but refrain from strenuous activities, lifting heavyweights, jumping, or running during this period.
• Do not stand, sit, or lie down for long periods of time. Keep your legs elevated while sitting.
• You should be able to resume most of your normal activities and return to work in a day or two.
• You need to call your healthcare provider if you have fever or notice swelling, pain, or infection at the catheter site despite taking your prescribed medications.
• A periodic follow-up appointment will be scheduled to monitor your progress.