phlebectomy

Phlebectomy, also known as ambulatory phlebectomy or microphlebectomy, is a surgical procedure to remove varicose veins by extracting them through small skin punctures. It is commonly performed in an outpatient setting under local anesthesia and does not require general anesthesia.

During the procedure, multiple small incisions (often 2 to 3 mm) are made along the length of the affected vein. A tiny hook or forceps is introduced through these punctures to grasp and remove segments of the vein one by one. The incisions are superficial and typically heal with minimal scarring. The procedure targets superficial tributary veins; larger saphenous system veins may be treated with other methods such as endovenous ablation or ligation as part of a comprehensive plan.

Preparation and aftercare involve preoperative duplex ultrasound mapping to identify incompetent segments. After the procedure, compression stockings are usually worn for one to two weeks, and patients are encouraged to walk and resume light activities within a few days. Swelling and bruising are common but typically resolve over weeks.

Risks and outcomes include potential complications such as infection, bleeding, hematoma, nerve injury causing numbness or altered sensation, skin discoloration, and scarring. Vein recurrence or new varicosities can develop if underlying venous insufficiency persists. Overall, phlebectomy has high rates of cosmetic improvement and symptom relief, especially when combined with treatment of the underlying venous insufficiency.

Phlebectomy is often part of a broader venous care strategy and may be used alongside other treatments such as sclerotherapy or venous ablation.