AMBULATORY PHLEBECTOMY

STEP 1: MARKING THE VEINS.

Some types of veins, including the perforator veins, pelvic veins, and truncal veins are only visible when using duplex ultrasound. Varicose veins, on the other hand, are clearly visible as they bulge through the surface of the skin when standing, and conceal themselves when lying down – like on the table.

As such, the bulging veins will need to be marked with a skin marker while you are standing up, allowing the physician to trace the exact position of the veins when you lie on the table. This is done by visual inspection of the varicose veins, palpation, and trans illumination of the skin, before tracing with a marker.

STEP 2: ANESTHESIA APPLICATION.

The area of procedure will then be cleaned, and the necessary preparations made with surgical drapes. There are some instances when phlebectomy is performed in conjunction with other treatments. If this is the case, phlebectomy will be performed last.

Otherwise, Dr. Shah will proceed by injecting a gentle local anesthetic into the skin around the veins, numbing both the veins and skin at the site of procedure. This injection can sting a bit, so you may request a mild, oral sedative.

STEP 3: PHLEBECTOMY PROCEDURE.

Using a sharp blade, the physician will make tiny incisions (2-3mm) over the veins in the marked areas.

A delicate hook-like instrument is then used to pull the varicose vein up through the skin, segment by segment. The vein is held and gently ‘milked’ out through the small cut until a sufficient amount has been pulled out, after which it is removed and discarded.

The entire process is relatively painless because the site has been numbed.

STEP 4: CLOSING THE INCISIONS.

The cuts made are so small that they don’t require stitching to close. Sticky tape is sufficient, and can be removed after 3 days.