Microphlebectomy for varicose veins otherwise known as ambulatory phlebectomy, involves the removal of diseased veins in the leg without surgery. Veins are structurally flexible and can collapse easily. Even large peripheral incompetent veins can be removed through small nicks in the skin.
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In Microphlebectomy, the diseased veins are removed in small segments through several slit like incisions in the skin. The extent of damage to veins decides the number of nicks required to remove those veins. Microphlebectomy is more commonly done to complement Endo Venous laser ablation and radiofrequency ablation.
Microphlebectomy is usually a better option to treat large, ropy abnormal veins over 5 mm in diameter but can be performed with smaller bulging veins. A review of individual medical history, medications, use of supplements and any medication allergies followed by tests and accurate diagnosis enables the decision to choose Microphlebectomy over other procedures. However, Microphlebectomy may not be the right choice for all kinds of veins and only a vascular specialist can guide you on the pros and cons.
Procedure
The procedure is done in an out-patient clinic by a Vascular Surgeon and it takes about 30 minutes to 1 hour under local Anaesthesia. The Surgeon will first identify the veins to be treated to ensure precise removal and to help preserve the health of surrounding veins and tissue. Tiny incisions of 1-3 mm in length are made in the skin over the targeted area of the diseased vein. Specialized instruments that look similar to small crochet hooks are used as tools in phlebectomy. The surgical hook will be inserted to extract the damaged veins section by section.
There is normally no experience of any discomfort during the procedure. Incisions will not require stitches and will heal on their own. The application of compression socks or bandages for several days or weeks following the procedure may be mandatory to prevent blood clots.
In most cases, the incisions are barely visible after 6-12 months. There may be mild skin pigmentation at the site of the removed vein but generally disappears after a few days. The patient will be able to walk and return to normal activities immediately after microphlebectomy. However, it is advised to avoid strenuous activities for 1-2 weeks from the date of the procedure.
Benefits
Microphlebectomy, not only offers symptomatic relief but also gives more comfort in the appearance of the affected leg. Microphlebectomy has proven to be an effective treatment for superficial varicose veins with a success rate of more than 90%. It has a lower varicose vein recurrence rate than sclerotherapy. Additionally, it is often the recommended treatment for large surface varicose veins that cannot be effectively treated with sclerotherapy. Microphlebectomy has gained importance as a foremost procedure in the modern management of varicose veins since it involves easy removal of large abnormal veins with faster recovery of the tissues when compared with other techniques.
Finally, Microphlebectomy is preferred over surgical stripping for the benefits of being a less invasive procedure resulting in quicker healing, less pain, and a better cosmetic result. Microphlebectomy may be done at the same time as the ablation procedure in the outpatient setting. More rapid recovery and minimal interruption of regular activity in a majority of patients after microphlebectomy, make it a popular choice of treatment.