Miniflebectomy

Micro-foam phlebectomy - what is it?

Micro-foam phlebectomy is a modern modification of classic miniphlebectomy. It involves the simultaneous administration of a foamed sclerosing (obliterating) drug into the vessel lumen, which causes significant vessel contraction and emptying of blood. Varicose veins are removed through a micro-incision or puncture performed under tumescent local anesthesia, using special phlebectomy hooks or mosquito forceps. This method is characterized by less tissue trauma and reduced intraoperative bleeding compared to classic miniphlebectomy. Foam miniphlebectomy is used at the Vein Clinic in difficult cases to increase treatment effectiveness, especially for secondary, recurrent, and standard sclerotherapy-resistant varicose veins. The procedure requires the operator to have experience in both sclerotherapy techniques and venous microsurgery.

Miniphlebectomy vs. phlebectomy - what are the differences?

Although these terms are often used interchangeably, there are subtle semantic differences between them. Phlebectomy is a general term for the surgical removal of a vein. Miniflebectomy on the other hand, is a minimally invasive variation of phlebectomy, in which veins are removed through skin punctures or 'mini-incisions' (1-3 mm in diameter). In practice, the term miniphlebectomy is often used as a synonym for ambulatory phlebectomy . Sometimes the term microphlebectomy, emphasizing the small size of the incisions. Importantly, the miniphlebectomy procedure does not require sutures, unlike traditional phlebectomy.

Classic phlebectomy, was once performed under general or regional anesthesia, while miniphlebectomy is performed under tumescent local anesthesia., which significantly reduces the risk of perioperative complications. Additionally, in the case of miniphlebectomy, it is possible to perform the procedure on an outpatient basis, and the patient can return home on the same day.

What can be treated using miniphlebectomy?

Miniflebectomy , performed contemporarily under tumescent infiltration anesthesia as part of the causal treatment of venous disease, is an effective and safe treatment method for:

• varicose veins of the lower limbs – especially those large and extensive ones that are visible as significant bulges under the skin;
• recurrent varicose veins (it's important to first treat pelvic vein insufficiency before addressing them!);
• varicose veins resistant to treatment with chemical methods, such as foam sclerotherapy or tissue adhesive;
• large varicose veins located in the intimate areas (it is always necessary to treat the underlying cause before performing miniphlebectomy).

Limitations of the miniphlebectomy procedure?

Miniphlebectomy has certain limitations that should be considered when planning the treatment of venous disease:

Price range

Description of the miniphlebectomy procedure:

At the Phlebology Clinic, the miniphlebectomy procedure is performed with the highest standards of safety and patient comfort.

• immediately before the procedure, vein mapping is performed under ultrasound probe guidance. The operating physician marks the course of the varicose veins to be removed on the skin, as well as the planned puncture points or vascular access sites.
• anesthesia: during the procedure, tumescent local anesthesia is used; during this anesthesia, a special anesthetic solution is injected under the skin, which reduces pain and the risk of bleeding. Tumescent anesthesia is safe even for patients with cardiac problems.
• puncturing of venous vessels or micro-incisions: after anesthetizing the skin and subcutaneous tissue, the doctor makes small punctures or micro-incisions in the skin (1-3 mm); these usually do not require sutures.
• removal of varicose veins: using a special hook (resembling a small crochet hook), the surgeon gently pulls out fragments of the varicose veins. The procedure is precise and minimally invasive.
• dressing: after the removal of varicose veins, special plasters are applied to the puncture sites; a local pressure dressing and an adhesive bandage are applied to reduce the risk of bleeding; everything is additionally supported by a compression stocking applied by the nurse.

The miniphlebectomy procedure typically lasts from 30 to 120 minutes.

Post-procedure management following ambulatory phlebectomy:

After a miniphlebectomy procedure, it is essential to strictly follow your doctor's recommendations. This is to accelerate proper healing and minimize the risk of complications:

• for the first night after the procedure, you should maintain the compression applied by the nurse (compression bandage along with a class II compression stocking);
• on the day following the procedure – after a check-up of the operated limb – only a compression stocking is put on, and a local dressing is applied;
• from the second day after the procedure, the compression stocking should be worn during the day for the period indicated by the doctor (usually 2-3 weeks);
• during the period of wearing the compression stocking, strenuous physical exercise and exertion should be avoided;
• walking for 30 minutes a day is recommended to help blood circulation;

• prolonged standing or sitting should be avoided (daily walks lasting 20-40 minutes are recommended);
• the date of the follow-up appointment is determined by the phlebologist; this date should be arranged with the Registration Desk of the Phlebology Clinic.

Contraindications for saphenectomy procedure

There are certain contraindications to performing a miniphlebectomy procedure. The most common of these include:

• active skin infections in the treatment area (dermatitis, cellulitis);
• developed lymphedema;
• severe systemic diseases;
• allergy to anesthetic drugs
• pregnancy;
• deep vein thrombosis;
• significant coagulation disorders;
• inability to wear compression stockings and compression (e.g., patients with advanced atherosclerosis of the lower limb arteries);
• inability to move around after the procedure;

Complications of endovenous laser ablation

The Microphlebectomy procedure is considered safe, but like any medical procedure, it may be associated with the risk of complications. The most common include:

• hematomas and bruising (resolve spontaneously – usually within 2-3 weeks);
• temporary sensory disturbances (in the area of the removed varicose veins);
• local swelling of the subcutaneous tissue;
• skin discoloration (usually temporary);
• very rarely: infection of the treatment site or superficial vein thrombosis;
• exceptionally rarely: post-operative deep vein thrombosis.

Most complications after miniphlebectomy are temporary and do not require medical intervention. If any concerning symptoms occur, you should contact your treating physician immediately.