Ambulatory phlebectomy is an outpatient procedure that removes superficial veins through very small, pinhole incisions in the skin. It can be considered the “gold standard” to remove segments of varicose or reticular veins of any size.
Ambulatory phlebectomy, stab avulsion, microphlebectomy are synonymous terms to define this local anesthetic outpatient, office-based technique.
Ambulatory phlebectomy is a good choice for treating both asymptomatic and symptomatic superficial veins that bulge above the surface of the skin, and may be combined with other therapies in the treatment of venous diseases.
The procedure is performed under local anesthesia: bulging veins are surgically removed, segment by segment, through small incisions, usually using an 18-gauge cutting needle or an ophthalmologic blade, with no residual scars; a hook is inserted into the incisions to grasp the veins and to bring them up and out of the openings.
The veins are then grasped between clamps and, with gentle traction, teased out of the puncture site. Very long segments can often be removed through a single incision. At the end of the procedure the puncture sites are covered with sterile plasters and dressings, and wrapped with soft gauze roll and bandages or graduated compression stockings; compression stockings are worn for at least two weeks after the procedure.
Patients can walk immediately after surgery and carry on normal daily activities; heavy aerobic exercises are allowed after two weeks. Pain is generally minimal as long as graduated stockings are worn.
Possible side effects are represented by temporary bruising and swelling, inflammation, blisters, skin numbness.
Allergic reaction to local anesthesia is a risk inherent to any surgical procedure.