Ambulatory Microphlebectomy, involving the removal of veins through tiny incisions, is the primary procedure we perform to surgically treat varicose veins. Other procedures include ligation (tying off of a vein) and stripping (removal of a long segment of vein by pulling it out with a special instrument) and are recommended only in special situations.

The Background

• Ambulatory Microphlebectomy, is a minor surgical procedure to remove surface varicose veins.
• A patient may undergo a lower extremity ultrasound exam to determine the status of the venous system prior to the scheduled phlebectomy.
• This procedure is usually performed in the office using local anesthesia.
• Patients may have an existing condition that would not make them an immediate candidate for a microphlebectomy, for example: infectious dermatitis or cellulitis in the area to be operated upon, severe peripheral edema, severe cardiovascular and/or pulmonary problems, uncontrolled diabetes and immunocompromise.

The Procedure

• Precise preoperative varicose vein markings are performed by a VI physician.
• Local anesthesia is administered via injection.
• Horizontal tiny (micro) incisions are made in the areas of treatment. A surgical hook device is introduced through the incisions to help remove the faulty veins.
• After the veins have been removed, the leg is washed and bandaged - incisions are tiny and stitches are generally not necessary. Typically, the procedure leaves nearly imperceptible puncture mark scars.
• A compression stocking is worn for a short period.

Post Procedure

• All patients are able to go home directly following the procedure. However, we recommend patients have someone who can drive them home.
• In addition, we have patients "walk about" for 10-15 minutes to check for postoperative bleeding and to ensure the wrapping is comfortable and manageable.
• Patients are encouraged to walk as much as possible and any accompanying pain is usually controlled with Ibuprofen. If larger segments of veins have been removed, Tylenol with Codeine or Hydrocodone is used.
• Patients usually return to the office in two weeks for a check-up.
• A VI physician is on call 24/7 to respond to any post-operative need.

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