phlebektomia

Phlebektomia, or phlebectomy, is a surgical procedure to remove varicose veins by extracting segments of a superficial vein through small skin incisions. It is commonly performed on leg veins and is usually an outpatient procedure performed under local anesthesia, sometimes with sedation.

Indications for phlebectomy include symptomatic varicose veins that cause pain, heaviness, or swelling, veins that are easily visible or felt, and cosmetic concerns. It is often used for tributaries of a refluxing superficial system or for isolated varicose veins when other non-surgical treatments are not sufficient.

Techniques commonly used are ambulatory or microincisional phlebectomy. The surgeon makes several tiny incisions along the path of the target vein and uses a hooked instrument or forceps to extract vein segments through these openings. The procedure can be performed with tumescent anesthesia to minimize bleeding and provide local analgesia. Phlebectomy may be done as a standalone treatment or in combination with other procedures for venous insufficiency, such as endovenous ablation or sclerotherapy of the main trunk.

Recovery and aftercare typically involve leaving the incisions clean and dry, wearing compression stockings for a period of time, and gradually resuming activity. Bruising and soreness usually subside within a few weeks. Most patients go home the same day.

Risks associated with phlebectomy include bleeding, infection, hematoma, scarring, pigmentation changes, and nerve injury (most commonly affecting nearby sensory nerves). Recurrence or the development of new varicose veins can occur, particularly if underlying venous reflux is not addressed.

Overall, phlebectomy is considered effective for removing small to medium-sized varicose veins and improving symptoms and appearance when performed by experienced surgeons.