Microphlebectomy removes large varicose veins close to the skin. Unlike the older method called "phlebectomy" that required bigger incisions, microphlebectomy uses much smaller incisions, around 2-3 mm (less than 1/8 inch).
Microphlebectomy is an important procedure for treating varicose veins because it removes large abnormal veins and allows for faster tissue recovery compared to other techniques. It is typically used to treat large, thick varicose veins over 5 mm in diameter. While foam sclerotherapy is another option for treating these veins, it can sometimes cause a cord-like structure or dark pigmentation on the skin that lasts for months. Patients who choose microphlebectomy often experience better-looking results sooner. Most patients develop small white scars at the microphlebectomy sites within six months after the procedure.
Before the procedure, most patients take a small dose of an anti-anxiety medication by mouth and a pain-relief tablet. Some may opt for non-narcotic drugs like naproxen or ibuprofen. The veins' location is marked on the skin while the patient is standing. The procedure is then performed in an operating room.
After preparing the skin and covering the leg with sterile draping, local anesthetic is injected around the veins using a small needle. Tiny incisions, about 2-3 mm in length, are made next to the veins using a scalpel blade. A small stainless steel hook is inserted through the incision to pull the vein out. This technique allows even large veins, measuring 20 mm or more in diameter when filled with blood, to be pulled through 3 mm incisions. The total blood loss during the procedure is usually minimal, less than a tablespoonful.
Following the procedure, a surgical dressing is applied over the incisions and a compression wrap is used. Two days later, the patient removes the dressing, takes a shower, and applies light pads over the incisions. They can resume wearing elastic support hose at this time. Walking is encouraged the day after the procedure. Runners can usually return to running within seven days, depending on their tolerance. Most patients manage discomfort with naproxen or ibuprofen, needing little to no narcotic pain medication.