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Another less invasive surgical procedure that targets larger branch surface veins involves using tiny small stab incisions to remove (avulse) veins. This procedure is called a phlebectomy. This doesn’t require general anaesthetic or hospitalisation and as the patient can continue normal activities is often called an ambulatory phlebectomy.

The unwanted varicose veins are removed through a series of tiny incisions along the path of the enlarged vein. Only local anaesthetic is required for this procedure. The technique used is called stab avulsion, in which 3mm stabs are made with a pointed scalpel and a surgical hook catches the vein and pulls it out. The 3mm cuts are then closed with steri-tape and do not need sutures and scarring is minimal. After the vein has been removed, a bandage and/or compression stocking is worn for usually one week. You can walk immediately and carry on normal daily activities except for exercise and heavy lifting usually for 1 week. Localised bruising and swelling is normal and temporary.

The combination of non surgical ultrasound guided techniques combined with phlebectomy has become increasingly popular.

Demonstration of Microphlebectomy