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What is Phlebectomy/Vein Stripping?

Veins are blood vessels that transport oxygen-poor blood from various parts of the body to the heart for purification (oxygenation). Varicose veins are swollen veins that can be seen under your skin as blue, bulging, and twisted veins. Varicose veins can occur due to various factors such as being overweight, familial history, not enough exercise, smoking, pregnancy, or sitting or standing for long periods of time. Varicose veins may cause rashes, redness or sores on the skin, aching pain, and a feeling of fatigue in the legs.

Phlebectomy/vein stripping is a minimally invasive procedure to treat varicose veins in your legs. It involves the removal of these bulged veins using a small scalpel, needle, or hook through small incisions made in the skin. This is an outpatient procedure so you will be able to go home the same day.

Indications for Phlebectomy/Vein Stripping

A phlebectomy/vein stripping procedure is indicated to remove superficial varicose veins of the leg. It is usually indicated for larger veins bulging from the surface of the skin and is rarely used on smaller veins. This procedure helps to manage and treat varicose vein symptoms, such as:

  • Swelling
  • Itching
  • Skin colour changes
  • Bulging or large veins on the skin surface
  • Heavy or painful feeling in your legs

Preparation for Phlebectomy/Vein Stripping

Pre-procedure preparation for phlebectomy/vein stripping may involve the following steps:

  • A thorough history and physical examination and routine tests
  • Informing your physician about all the medicines or supplements you are taking
  • Disclosing any medical conditions you have such as a bleeding disorder or heart disease
  • Refraining from blood thinners, anti-inflammatories, aspirin, or other supplements for a week or two
  • Informing your doctor of any allergies to medications, anaesthesia, or latex
  • Arranging for someone to drive you home after the procedure
  • Signing a consent form after the risks and benefits of the procedure has been explained

Procedure for Phlebectomy/Vein Stripping

During the phlebectomy/vein stripping procedure, your doctor will numb the area of the varicose vein with local anaesthesia. The skin is then cleansed and a series of small incisions of about 1 mm is made in the skin near the affected vein. Then, a phlebectomy hook (a hook with a blunt tip and a straight shaft) is inserted under the skin surface, and the varicose vein is removed through the tiny incisions. Veins can easily collapse, so even large veins can be removed through these incisions. The incisions are very small and do not require sutures to close them but instead are covered with a small bandage. This procedure usually takes about 30 minutes to an hour.

Post-Procedure Care and Recovery

In general, post-procedure care instructions and recovery after phlebectomy/vein stripping may involve the following:

  • You may experience pain and swelling in the treated leg. Medications are prescribed as needed to address these.
  • Application of ice packs over the treatment area is also recommended for 10 minutes at a time for a few days to manage bruising, swelling, or pain.
  • You are advised to wear compression stockings for a few days to weeks as this can help prevent blood pooling or clotting, as well as swelling of the leg.
  • You are encouraged to walk 10 to 20 minutes about 3 times a day for a couple of weeks, but you should refrain from strenuous activities, lifting heavy weights, jumping, or running during this period.
  • Do not stand, sit, or lie down for long periods of time. Keep your legs elevated while sitting.
  • You should be able to resume most of your normal activities and return to work in a day or two.

Benefits of Phlebectomy/Vein Stripping

Some of the benefits of phlebectomy/vein stripping include:

  • Smaller incisions
  • Little or no scarring
  • Reduced surgical risks compared to the traditional method
  • Simple outpatient procedure
  • Quicker recovery

Risks and Complications of Phlebectomy/Vein Stripping

Phlebectomy/vein stripping is a relatively safe procedure; however, as with any procedure, some risks and complications may occur, such as the following:

  • Bleeding
  • Infection
  • Pain
  • Bruising/swelling
  • Nerve injury
  • Skin pigmentation

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