Phlebectomy

Phlebectomy, also known as ambulatory phlebectomy or microphlebectomy, is a minimally invasive surgical procedure used to remove varicose veins from the legs.

Indications

The procedure is typically indicated for patients with:

• Varicose veins that are causing symptoms such as pain, swelling, or skin ulcers
• Large or prominent varicose veins that are cosmetically undesirable
• Failed sclerotherapy or endovenous laser treatment

Procedure

The phlebectomy procedure involves the following steps:

1. The patient is given local anesthesia to numb the area where the varicose vein is located.
2. A series of small incisions (typically 1-2 mm in length) are made along the length of the varicose vein.
3. A specialized instrument called a phlebectomy hook is inserted through each incision to grasp and remove the varicose vein.
4. The vein is then pulled out through the incision, and the process is repeated for each section of the varicose vein.

Types of Phlebectomy

There are two main types of phlebectomy:

• Ambulatory phlebectomy: This is a minimally invasive procedure that can be performed in an outpatient setting, and the patient can walk immediately after the procedure.
• Transilluminated powered phlebectomy: This is a more advanced procedure that uses a special light source to illuminate the varicose vein, allowing for more precise removal.

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with phlebectomy, including:

• Bleeding or hematoma
• Infection
• Nerve damage or numbness
• Scarring or keloid formation
• Recurrence of varicose veins

Recovery and Aftercare

After the procedure, patients typically experience:

• Mild to moderate pain or discomfort, which can be managed with over-the-counter pain medication
• Swelling or bruising, which usually resolves within a few weeks
• A compression bandage or stocking is worn for several days to help reduce swelling and promote healing
• Patients are encouraged to walk and resume normal activities as soon as possible to prevent blood clots and promote circulation

Outcomes and Success Rates

The success rate of phlebectomy is generally high, with:

• 90-95% of patients experiencing significant improvement in symptoms and appearance
• Recurrence rates are relatively low, ranging from 5-10%