Ambulatory Phlebectomy

How does the procedure work?

Ambulatory Phlebectomy is a minor surgical procedure which allows for the removal of large surface varicosities through very small incisions that need no stitches. The procedure is normally done in the office at Pacific Vein Care using a superficial local anesthetic.

The procedure normally takes approximately one hour. There is very little discomfort with the procedure and very little “down time” during your recovery. Most people who work can go back to work the day of the procedure, although many patients take the day off just to be sure they are fully recovered before returning to work.

After cleansing and anesthetizing the skin, minute skin incisions are made with an instrument that limits the size of the micro-incision to 1.5 mm. Another instrument is inserted under the surface of the skin to extract a length of the varicose vein through this micro-incision.

With this procedure, a compression bandage is worn for 24 hours. After this, a support stocking is worn until all bruising resolves, usually in about one more week. The compression bandage and support stocking minimizes swelling and discomfort and allows for proper healing.

The Ambulatory Phlebectomy Procedure:

1. Some patients take a mild sedative about one hour before the procedure to help them relax. This is not required and only about 5% of our patients opt for a sedative. We will give you a prescription for this mild sedative when we schedule the procedure.

2. The areas to be treated are marked with an indelible marker while you are standing.

3. You then lay down on an examination table and the area of the leg to be treated is cleansed with a sterile disinfectant soap.

4. A sterile drape is then put in place to cover the non-sterile parts of your skin we don’t want to touch.

5. A small area of skin is then anesthetized with a local anesthetic, right over one of your varicose veins. The anesthesia is to numb the area around the targeted vein.

6. Through this anesthetized skin, a 1.5 mm micro-incision is made.

7. Through the micro-incision fine surgical instruments are used to extract as great a length of the varicose vein as can be reached from the micro-incision. Normally, this is a length of about one inch in either direction, so about two inches of vein can be extracted through one micro-incision.  This is repeated through the area previously numbed.

8. Another area of skin is anesthetized with a local anesthetic, usually starting about 2 inches from last micro-incision, and steps # 6, 7 and 8 are repeated until the entire length of the varicose vein is removed.

10. We put some steri-strips over your micro–incisions, we then wrap your leg in a comfortable but snug compression wrap, and you walk out of the office with a healthier leg!

The Benefits and Expected Results

  • A very simple procedure
  • Performed under local anesthetic in the Doctors Office
  • Cost effective. It does not incur any charges from the hospital or an anesthesiologist.
  • Minimally invasive, so minimal risk of scarring or postoperative infection
  • Approximately one hour treatment time
  • Rapid recovery with reduced postoperative pain
  • Normal activities can be resumed immediately
  • Excellent clinical and cosmetic results

If you take the sedation you will need a driver to take you home after the procedure.