Microphlebectomy is a minimally invasive procedure that allows for the removal of large, superficial varicose veins through very small incisions that most likely do not require any stitches. These incisions are generally 2-6 mm in length. Unlike traditional, more invasive surgeries this can be done in our office.
Prior to treatment a physical examination is done and a complete vein history is taken by your surgeon, as well as an ultrasound. Based on the physical examination and any test results, your surgeon may recommend you have a microphlebectomy. The long term results of microphlebectomy are excellent when performed by a skilled vascular surgeon for the appropriate medical reasons.
The procedure itself takes about an hour. First, with the patients consent, photographs may be taken of the veins in the leg to be treated for insurance, education, and marketing purposes. The veins are then marked with a skin marker while the patient is standing so they can be visualized better. The leg is washed with a solution to kill any germs on the skin to prevent infection. Sterile drapes are applied and the skin over the veins is numbed with a local anesthetic. A different numbing medicine, with epinephrine in it (to constrict the vein), is sometimes injected deeper around the vein to be removed. Once the area is numb a very small incision is made over the top of the vein and a small hook is used to locate the vein and pull it up through the skin to be removed. A pulling sensation is usually felt but not pain. This process is repeated until all of the varicose veins that were marked are gone. A small, internal stitch may or may not be used based on the size of the incision and whether or not the site is bleeding. The skin is then cleansed and a small adhesive strip is placed over the incisions to hold the skin edges together. An absorbent pad is placed over these areas to catch any drainage from the medicine we inject and compression hose are applied over this. This dressing stays on for the next 48 hours.
Mild to moderate pain can be expected after this procedure as well as bruising. The amount of pain is due, in part, to how many incisions are made and a pain medicine may be prescribed. You should take the entire day off work and you should keep your leg elevated as much as possible. Compression hose are put over the dressing and worn continuously for the first 48 hours. Then you will only need to wear them while up and moving about for 2 weeks afterwards.
There is some element of risk with any medical procedure. Only mild complications have been associated with this procedure including: bruising, swelling, scar formation, permanent pigment staining of the skin, temporary phlebitis, superficial clot formation, failure to eliminate veins, minor infection, and mild allergic reaction to any medicines used. There is the remote possibility, as with any medical procedure that more serious complications could occur including, but not limited to: severe allergic reaction (anaphylaxis), deep venous blood clot, pulmonary embolism, significant bleeding, or death.