Ambulatory Phlebectomy

An ambulatory phlebectomy, also called a microphlebectomy or stab phlebectomy, is an outpatient procedure performed to remove spider and varicose veins through small, slit-like incisions in the skin. When varicose veins near the surface of the skin are too large to treat with sclerotherapy and too small to treat with laser ablation, microphlebectomy is the preferred treatment. Since veins are extremely collapsible, even the largest affected veins can often be removed through tiny incisions using the ambulatory phlebectomy procedure. This minimally invasive treatment does not require sutures or general anesthesia and can easily be performed in the doctor‘s office with minimal downtime. Ambulatory phlebectomy involves less pain and fewer risks than traditional surgical treatment.

Reasons for Ambulatory Phlebectomy

Some patients seek treatment for their varicose veins for cosmetic purposes, while others are concerned about the potential risks of their damaged veins. Untreated veins can lead to pain, inflammation and discoloration. They can also affect the flow of oxygen-depleted blood between the lower legs and the heart. Ambulatory phlebectomy treats symptomatic and asymptomatic veins and can relieve both cosmetic and medical concerns in one simple procedure. After damaged veins have been removed, other healthy veins in the leg will absorb the excess blood and reinstate a normal blood flow. Functioning will not be affected by removing the damaged veins, as there are many surrounding veins to take over.

Who Is An Ideal Candidate For Ambulatory Phlebectomy?

Ambulatory phlebectomy is generally recommended for patients with bulging, protruding varicose veins that are causing physical symptoms as well as their unsightly appearance. Symptoms might include: Heaviness or aching in the lower leg Swelling of the lower leg and foot Restless legs or leg cramps at night Skin irritation around the swollen vessel If this condition is left untreated, it can continue to worsen and keep you from enjoying certain activities due to discomfort and embarrassment. Skin changes may begin to include discoloration of the skin and the formation of open sores around the ankle, known as venous ulcers. The good news is that by removing the affected veins from the leg entirely, we can also effectively eradicate the symptoms, prevent further complications and improve your quality of life overall.

Are the Results of Ambulatory Phlebectomy Permanent?

The ambulatory phlebectomy procedure completely removes damaged veins so produces effective, satisfying results right away. Because the veins are removed, the results of the ambulatory phlebectomy treatment are expected to last indefinitely. That said, it is possible for new veins to develop over time. People with a history of varicose veins have a higher risk of developing new veins at some point. This risk can be minimized through healthy lifestyle habits that include weight management and daily physical activity.

How Soon After the Microphlebectomy Procedure Can I Expect to See Results?

After microphlebectomy, the bulging vein will be gone. Minor swelling and bruising occur after the procedure. These side effects may fade in as little as one week or as many as three. To optimize the healing and cosmetic improvement after ambulatory phlebectomy, it is important to carefully follow the post-treatment care instructions provided by our office. With good care, you can expect to see minor improvements as each day passes until, three to four weeks after your procedure, you see a smooth, healthy leg.

Is Microphlebectomy Painful?

No. When beginning the procedure, the doctor administers a local anesthetic around the target vein or veins. This works quickly to numb nerves around the veins, and the medication stays in effect for the duration of the procedure. Patients can expect the feel a minor pinching sensation as the medication is administered, but this fades right away as the anesthetic begins to work. After microphlebectomy, comfort is supported through the use of over-the-counter pain-relieving medication and compression stockings, which may be worn several hours a day for a few days after treatment.

Ambulatory Phlebectomy Procedure

The ambulatory phlebectomy procedure is performed on an outpatient basis. This procedure takes about 45 to 60 minutes to perform. The doctor will first identify the veins to be treated to ensure precise removal and to help preserve the health of surrounding veins and tissue. Before beginning the surgery, the doctor will inject a local anesthetic into the skin. Patients generally do not experience any discomfort during the procedure. Tiny incisions will be made in the targeted areas, and a surgical hook will be inserted to extract the damaged veins section by section. The incisions are very small and frequently no stitches are required. Veins are very collapsible such that even large veins may be removed through the tiny incisions used in this technique. The patient will be required to wear compression bandages for a week after surgery to help minimize swelling and discomfort.

Risks of Ambulatory Phlebectomy

Patients who are allergic to local anesthesia or those who cannot wear compression stockings should not undergo the ambulatory phlebectomy procedure. Any active infections or rashes should be thoroughly treated before this procedure as well.. Although an ambulatory phlebectomy is considered quite safe, there are certain risks associated with any surgical procedure. In a few cases, there may be residual inflammation and irritation resulting from an incomplete removal of damaged veins. Other risks may include:

  • A nerve injury to the skin
  • Adverse reaction to anesthetic or sedative
  • Severe bleeding or swelling
  • Numbness or pain in the feet
  • Post-surgical infection
  • Thrombophlebitis

Recovery from Ambulatory Phlebectomy

Some bruising, discomfort and swelling are to be expected after an ambulatory phlebectomy. Swelling and pain can be minimized with compression garments and over-the-counter pain medications, and are usually only temporary. Patients will be able to walk and carry on with normal activities immediately after the ambulatory phlebectomy procedure, though they will have to wear compression stockings for the first week. They can usually return to work the next day, although exercise and heavy lifting should be avoided for about two weeks.

The incisions from this procedure do not require sutures and are able to heal on their own, and are often barely visible after six to twelve months. Some patients may experience mild skin pigmentation at the site of the varicose vein, but this usually goes away on its own after a short time. Most people see effective results from an ambulatory phlebectomy since damaged veins have been completed removed. Ambulatory phlebectomy offers permanent effective results for most patients, although it is possible for new varicose veins to develop, particularly in patients with a family history of varicose veins. The risk of recurrence can be minimized if the patient maintains a proper weight and an active lifestyle.

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