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settings."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":2,"max":4,"unit":"weeks","qualifier":"Walking encouraged immediately; strenuous exercise and heavy lifting resumed after about 2-4 weeks as comfort and wound healing allow."},"final_result_months":{"min":1,"max":3,"unit":"months","qualifier":"Bruising and induration resolve over weeks; final cosmetic and symptomatic result by about 1-3 months."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"After wound check and compression review; short-haul flights may be earlier, with DVT-prevention measures on longer flights."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Wound review, suture or dressing removal and compression check."}},{"purpose":"assessment","requirement":"routine","after":{"min":30,"max":90,"unit":"days","qualifier":"Clinical review, often with duplex ultrasound, for residual veins and complications."}}],"indications":["Symptomatic great or small saphenous vein reflux with varicose veins","Saphenous reflux venous insufficiency with skin changes, edema or ulcers","Recurrent superficial thrombophlebitis or bleeding from varices"],"main_risks":["Bruising and hematoma","Saphenous or sural nerve injury causing numbness or paresthesia","Wound infection","Deep vein thrombosis and pulmonary embolism","Lymphatic leak or lymphocele in the groin","Recurrence including neovascularization","Bleeding","Anesthesia-related risks"],"pain":"Mild to moderate pain and tightness along the leg for several days, usually controlled with standard oral analgesics; bruising may be marked.","preparation":["Duplex ultrasound mapping of venous reflux and marking of veins","Pre-anesthesia assessment and routine tests as indicated","Fasting before general anesthesia per clinic instructions","Review of medications with the surgical team","Arrange compression stockings and transport home","Stop smoking where possible"],"recovery_timeline":[{"phase":"Day 0-3","description":"Compression bandaging, early walking, analgesia; bruising and tightness.","restrictions":["Avoid prolonged standing or sitting","No strenuous activity"]},{"phase":"Week 1-2","description":"Wound check, return to desk work, continued compression stockings.","restrictions":["Avoid heavy lifting","Avoid hot baths until wounds heal"]},{"phase":"Week 2-4","description":"Gradual return to full activity and exercise as bruising fades.","restrictions":["Build up strenuous exercise gradually"]},{"phase":"Month 1-3","description":"Resolution of bruising and induration; final result assessed.","restrictions":[]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Ordinary functional recovery to daily activities; no formal physiotherapy normally required."},"result_longevity":"Removes the treated saphenous trunk permanently, but new varicose veins or recurrence can develop over years because of ongoing venous disease.","revision_rate_pct":{"min":10,"max":25,"unit":"percent","qualifier":"Repeat treatment for recurrent varicose veins within 5 years, including sclerotherapy or reoperation."},"scars":"Small groin incision and a few small incisions or stab avulsion marks along the leg; usually fade to fine scars over months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One operation; both legs can be treated in the same session."},"stages":[{"code":"stripping_surgery","label":"High ligation and stripping of the saphenous vein with phlebectomies","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed at the initial procedure."}}],"qualifier":"Typical single-stage surgery, one or both legs."},"success":{"metric":"Freedom from symptomatic recurrent varicose veins","value":75,"unit":"percent of patients","horizon":"5 years","population":"Adults with symptomatic great saphenous reflux undergoing high ligation and stripping","evidence_status":"limited"},"techniques":[{"name":"High ligation with great saphenous vein stripping and stab phlebectomy","suits_whom":"Symptomatic great saphenous reflux with varicose tributaries.","recovery":"Return to desk work in about 1-2 weeks with compression."},{"name":"Short saphenous vein ligation and stripping","suits_whom":"Small saphenous reflux; requires careful duplex mapping to protect the sural nerve.","recovery":"Similar to great saphenous surgery."},{"name":"Invaginating stripping","suits_whom":"Selected patients; aims to reduce bruising and tissue trauma.","recovery":"Similar or slightly faster recovery."},{"name":"Cryostripping","suits_whom":"Selected patients; aims to reduce bruising and tissue trauma.","recovery":"Similar or slightly faster recovery."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Per leg for ligation, stripping and phlebectomies; bilateral surgery takes longer."},"initial_assessment_documents":["Leg venous duplex ultrasound report","Standing photos of both legs, front and back","Previous vein treatment or surgery records","List of blood thinners","History of deep vein thrombosis (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay 7-14 days for wound check and suture or dressing removal before flying home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask why stripping is offered, and confirm simpler procedures are unsuitable for you","scope":"procedure","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"You may be offered surgery to remove varicose veins, called ligation and stripping, if simpler procedures are not suitable for you.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that a duplex ultrasound scan is done first to confirm the diagnosis and plan treatment","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"If you're referred to a specialist they'll usually do a test called duplex ultrasound to confirm if you have varicose veins and plan your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that the specialist explains the benefits and risks of the treatment offered","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"The specialist will explain which treatment may be best for you, and the benefits and risks.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Stripping offered with no explanation of why simpler procedures are unsuitable for you","scope":"procedure","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"You may be offered surgery to remove varicose veins, called ligation and stripping, if simpler procedures are not suitable for you.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"No specialist explanation of benefits and risks before the treatment is offered","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"The specialist will explain which treatment may be best for you, and the benefits and risks.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"Surgery offered without a duplex ultrasound scan to confirm the diagnosis and plan treatment","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"If you're referred to a specialist they'll usually do a test called duplex ultrasound to confirm if you have varicose veins and plan your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-13","next_check_at":"2027-02-11"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription 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only be offered compression stockings for varicose veins if procedures or surgery are not suitable for you, or if you do not need other treatments.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"high-ligation","name":"High ligation with great saphenous vein stripping and stab phlebectomy","how_it_works":{"text":"A wire pulls the vein out of the leg","source":{"url":"https://www.nhs.uk/conditions/varicose-veins/treatment/","host":"nhs.uk","quote":"The surgeon uses the wire to pull the vein out.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":4,"max":4,"unit":"weeks","label":"4 weeks","source":{"url":"https://www.healthline.com/health/varicose-vein-stripping","host":"healthline.com","quote":"By the fourth week, you can probably return to your 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