What Is a Phlebectomy and When Do You Need It?

Phlebectomy is a surgical method for the treatment of varicose veins, in which an operation is performed to remove sections of varicose veins. Subcutaneous veins are removed, and the blood flow is no more than 10% of the total volume. The deep veins, which carry the bulk of the blood, easily adapt to such a slight increase in load. As a result of the operation, the outflow of blood is normalized, and an aesthetic effect is achieved.

Indications for Phlebectomy

The indications for phlebectomy are:

• Extensive varicose veins.
• Pathological expansion of the saphenous veins.
• Increased fatigue and swelling of the legs with varicose veins.
• Signs of impaired blood outflow (heaviness in the legs, edema, observed even in the absence of pronounced varicose veins of the superficial veins).
• Complications of varicose veins (trophic ulcers, thrombophlebitis).

Phlebectomy is a radical method of treating varicose veins and is used when the disease has already gone beyond the initial stage, and other methods of treatment are ineffective. Currently, phlebectomy is not considered a dangerous surgery, and modern implementation methods aim to minimize the damage caused to the body as a result of surgery. Therefore, if there are indications for phlebectomy, it should not be postponed.

Contraindications for Phlebectomy

Phlebectomy contraindications are:

• Late stage of varicose veins (with deep vein thrombosis).
• Certain cardiovascular diseases (severe arterial hypertension, coronary heart disease).
• inflammatory processes on the legs (erysipelas, eczema, etc.).
• Severe infectious diseases.

Phlebectomy is also not done to elderly people and women during the second and trimesters of pregnancy.

How Is Phlebectomy Surgery Performed? 

Before the operation, you need to be examined by a phlebologist and, if necessary, an ultrasound scan. As a rule, a combined phlebectomy is performed, which is a combination of different methods used depending on which vessels are affected by varicose veins and what is the degree of damage. Combined phlebectomy includes:

• Crossectomy - the intersection of the saphenous varicose vein at the place where it flows into a deep vein.
• Saphenectomy - a traditional surgical intervention to remove large venous trunks.
• Stripping - removal of varicose veins using a thin probe (only the part of the vein changed by varicose veins is removed).
• Microphlebectomy - removal of a varicose vein through small punctures using a special hook.

The widespread use of the micro phlebectomy technique allows for achieving an aesthetic effect. The operation is performed through small incisions (4-5 mm) and leaves almost invisible scars behind.

Preparation for the operation is minimal –– it is enough to take a shower and carefully shave the hair in the operating area.

The operation is performed under spinal anesthesia. The planned operation time (including anesthesia) is 3 hours. The postoperative period of stay in the hospital is 1-2 days.

Post-Phlebectomy Care and Recovery

After the surgery, a compression stocking is put on the operated leg, which cannot be removed for three days. Physical therapy exercises and light massage are recommended. Heavy lifting and strenuous exercises should be avoided. In no case should you visit swimming pools, saunas, and baths.

In the first days after the operation, bruising may occur along the removed vein. After a few days, they should resolve, but some seals in their place may be observed for another 2-3 weeks.

The sutures are removed, as a rule, for 8-9 days. Compression underwear is then worn for at least a month. A follow-up examination with a doctor is scheduled two weeks after the operation. The next examination is done in two months and includes an ultrasound examination of the vessels.

With the exact implementation of all the doctor's prescriptions for the rehabilitation period after a phlebectomy procedure, it is usually possible to avoid undesirable consequences and quickly recover from the surgery.