Microphlebectomy

Prior to the advent of endovenous ablation (closure) procedures, after the vein was stripped out, the surgeon would take a scalpel blade and make a series of phlebectomy incisions in order to expose the distended side branches of the incompetent Great Saphenous Veins. This allowed the open dissection and ligation of these side branches, resulting in a series of disfiguring cross hatched incisions. As the technique matured, smaller “stab avulsion” incisions were used and pieces of the vein could be seized with clamps and removed from the body. The technique was further refined by our colleagues in France, Italy and Brazil, whose cultures demanded almost invisible incisions to compliment their beach attire. I was fortunate enough to have learned this technique at the Copa d’Or Hospital, located in the Copacabana district of Rio de Janeiro, Brazil. No scalpels are used. Micro-access to the veins is achieved with a standard venipuncture needle and a miniature hook device is used to deliver the edge of the vein to the surface where it can be grasped above the skin level and slowly teased out. Using this technique, I have delivered continuous vein segments up to 25 cm long from one site. The value of this technique is being able to remove all of the major residual side branches from endovenous ablated Great or Small Saphenous Veins to achieve that polished look, instead of waiting months for the residual veins to subside in size. This is really the difference between the in office 35 - 45 minute procedures and the professional results that I can achieve when I combine both procedures. Furthermore, Microphlebectomy is a far superior method for treating tortuous surface veins such as the: Anterior and Posterior Accessory Saphenous vein, Lateral Subdermic Vein, Anterior and Posterior Accessory Tibial veins and Paratibial veins. While Sclerotherapy is an option for these larger superficial veins it often takes more than a year for the veins and the associated staining to resolve. In contrast, Microphlebectomy results are achieved in 60 to 90 minutes and the healing time is measured in weeks, not months.