Ambulatory Phlebectomy

Do you hate those ugly medium to large blue varicose veins that develop on a hereditary basis as you get older?

For those with deep blue varicosities, the latest technique in ambulatory phlebectomy removes the vein or veins under local anesthesia, leaving virtually no scars. The procedure can also be performed without having to miss an evening out.

Ambulatory phlebectomy is a minimally invasive procedure, performed through pinhole incisions. This technique permits removal of almost all larger varicose veins as an office procedure performed under local anesthesia. It is often used in conjunction with sclerotherapy to reduce the pressure in the smaller telangectatias and spider veins resulting in more efficient sclerotherapy. Ambulatory phlebectomy is part of a complete program to eliminate unsightly or painful leg veins. Using a combination of sclerotherapy and ambulatory phlebectomy, almost all varicose veins of the leg can be successfully treated in the office with an excellent cosmetic result and little or no "down time". The results of the procedure have been excellent from a cosmetic and patient satisfaction point of view.

Procedure Prior to surgery the degree of reflux (backward flow) in the incompetent veins is evaluated by visualization, palpation and other methods. The location of the veins is determined by Doppler ultrasound, which picks up the sound of blood flowing the wrong way in the affected veins. The Venoscope is used to localize deeper vessels and to determine if the vessels shift position when the patient lies down. The vessels are marked with a surgical marker. The surgical procedure is done in our AAAHC certified surgical suite under local tumescent anesthesia.

Before After

Before After

The patient is comfortable throughout the procedure. Small pin hole incisions are made adjacent to the varicose veins and the veins are removed. There is almost no bleeding since there is no pressure in the veins. Usually no stitches are required.

After all the veins are removed, the leg is wrapped with an ace bandage and the patient can get up and walk around the office prior to going home. The patient will wear a support stocking for two weeks after surgery. Most patients are not at all uncomfortable and need no pain medication. Patients may stand, walk and return to work on the day following surgery. Strenuous activity is limited for two weeks.

Dr. David Narins has lectured on Ambulatory Phlebectomy at National Surgical Society Meetings, made a movie demonstrating the technique, and has taught other physicians how to do the procedure.