What is an Ambulatory Phlebectomy?

An ambulatory phlebectomy is a surgical procedure in which superficial varicose veins are removed from the legs through small incisions. Varicose veins are blood vessels that have become large and twisted. An ambulatory phlebectomy is usually performed as an outpatient procedure, or a procedure after which the patient does not need a hospital stay and may return home. The procedure may be performed to solve cosmetic problems with varicose veins or to prevent pain, clotting, and other complications associated with varicose veins.

Varicose veins typically appear as dark purple or blue, convoluted, bulging cords in the legs. These veins become enlarged because the valves that prevent the backflow of blood in a healthy vein fail to close entirely. Spider veins are similar, but are much smaller and may present in the face as well as the legs. Symptoms of varicose veins, besides appearance, may include aching, muscle cramping, and burning sensation in the legs, swelling in the lower legs, itching around the veins, discomfort after sitting or standing for a long period of time, and, in some cases, skin ulcers around the ankle. Pregnancy, family history of varicose veins, increasing age, being of the female gender, obesity, and standing for long periods of time increase the likelihood of developing varicose veins.

If the varicose veins are superficial, or close to the surface, they are fairly easy to remove through procedures such as ambulatory phlebectomy, vein stripping, sclerotherapy, laser surgery, or a catheter-assisted surgery. If complications, such as ulcers, arise that require the removal of deeper veins, it may require endoscopic vein surgery. In this surgery, the doctor inserts a camera into the leg to get an image of the offending vein and then closes and removes the vein through small incisions in the skin.

If a doctor recommends an ambulatory phlebectomy, a patient can usually expect to be in and out of the hospital in one day. This method of varicose vein removal can be used for either large or small superficial veins and is minimally invasive. A doctor will first make marks on the legs to show which veins will be removed and then give the patient a local anesthesia to numb the region. The doctor will then make tiny incisions or punctures in the leg, through which the veins are removed with surgical hooks. These incisions are so small that they usually require no stitches and cause little scarring.

After surgery, patients should not experience much discomfort. Patients can usually return to normal activities immediately, barring heavy lifting or exercise. Doctors often recommend that patients wear compression stockings for a time after the surgery. Compression stockings are stockings used to support blood circulation in the legs by squeezing the leg, most tightly around the ankle and decreasing in pressure as they travel up the legs. These stockings look almost identical to pantyhose, knee-high, or thigh-high stockings and are often used as a non-surgical treatment for varicose veins, as well as for post-surgical support.

Ambulatory phlebectomy is an option for patients with surface varicose veins that experience discomfort or cosmetic displeasure. Ambulatory phlebectomy is not a good option for patients with deep varicose veins that need attention because of pain, blood clotting, or ulcers. Patients with arterial circulation problems that prevent them from wearing compression stockings, patients that cannot walk, and patients who cannot tolerate local anesthesia should also look at other options for dealing with varicose veins.