What is an Ambulatory phlebectomy?
An ambulatory phlebectomy also called a microphlebectomy or stab phlebectomy, is an outpatient procedure. We perform this procedure to remove spider and varicose veins through small, slit-like incisions in the skin. If 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.
Ambulatory phlebectomy treats symptomatic and asymptomatic veins and can relieve both cosmetic and medical concerns in one simple procedure. After the removal of damaged veins, other healthy veins in the leg will absorb the excess blood and reinstate a normal blood flow.
Since veins are collapsible, even the largest affected vein can often be removed through tiny incisions using the ambulatory phlebectomy procedure.This treatment is minimally invasive and does not require sutures or general anesthesia. The doctor can easily perform this procedure in the office with minimal downtime. The ambulatory phlebectomy procedure is less painful and has fewer risks than most traditional surgical treatments.
First, the doctor will identify which veins need to be treated to ensure precise removal. This will help to 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.
The doctor will then make tiny incisions in the target areas, and insert a surgical hook to extract the damaged veins section by section. The incisions are very small and usually do not require stitches. We do require the patient to wear compression bandages for a week after surgery to help minimize swelling and discomfort. In total, the procedure takes about 45 to 60 minutes to perform.
Risks Of Ambulatory Phlebectomy
Patients who are either allergic to local anesthesia or cannot wear compression stockings should not undergo this procedure. Before proceeding with this procedure, you should treat any active infections or rashes you may have thoroughly before proceeding with this procedure as well. Although an ambulatory phlebectomy is considered quite safe, there are certain risks associated with this procedure. In a few cases, there may be residual inflammation and irritation resulting from an incomplete removal of damaged veins.
Some 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
Patients who do not treat these veins often experience discoloration, inflammation, and pain. They also risk affecting the flow of oxygen-depleted blood between the lower legs and the heart.
Following the procedure, patients can expect some bruising, discomfort and swelling. Patients can minimize their swelling and pain with compression garments and over-the-counter pain medications. Patients will be able to walk and return to their normal routines immediately after the procedure. For the first week following the procedure, they will have to wear compression stockings. They can usually return to work the next day, although they should avoid exercise and heavy lifting for about two weeks.
Most people see effective results from an ambulatory phlebectomy since damaged veins have been completely 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. If the patient maintains a proper weight and an active lifestyle, they can minimize the risk of recurrence. Since the incisions do not require sutures and are able to heal on their own, any scars 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 will usually go away on its own after a short period of time.