Miniphlebectomy

Miniphlebectomy is an operative technique that involves the removal of varicose veins using special surgical hooks while making minimal incisions on the skin. These cuts are so small that they do not require sewing the leather.
After the procedure, special pressure dressings (class II, 20-30 mm Hg) are put on and the patient wears them for about 3 weeks. Adequate limb compression minimizes the risk of postoperative complications.
 

Miniphlebectomy - what kind of varicose veins can be removed with this method?

Miniphlebectomy is usually an accompanying method in larger surgeries, although it can also be used separately, thus removing piercing veins (those that connect the superficial and deep veins), reticular veins, telangiectasias, varicose veins of the collateral vessels of the superficial veins, varicose veins of the perineum. It is worth remembering that strong vessels are better suited for the miniphlebectomy, while those that are thin-walled and tearing will be better suited to sclerotherapy. Quite often, miniphlebectomy is combined with sclerotherapy, due to the fact that during sclerotherapy, telangiectasias in the vein to be miniflebectomy are reduced or removed. Miniphlebectomy is especially useful for varicose veins in the elderly; removal of diseased veins that cannot be removed by other methods; as well as in the case of such "bleeding" varicose veins or so-called varicose pearls. In turn, the contraindication to this type of surgery is pregnancy and the puerperium period, as well as all kinds of infections or critical ischemia of the lower limbs.

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What does the miniphlebectomy procedure look like?

Before performing the miniphlebectomy procedure, the specialist doctor determines the course of the malfunctioning veins. Then he marks with a marker on the patient's limb the veins and varicose veins suitable for treatment. The patient then remains in a standing position. The next marker is made when the subject is lying down. By determining the course of diseased veins, the doctor can determine more precisely the places of anesthesia administration, or the best place to make skin incisions. The specialist also performs a Doppler examination using Duplex Doppler ultrasound. After this test is performed, the leg to be treated is disinfected and prepared for the procedure. Miniphlebectomy is a procedure that uses infiltration anesthesia. It consists in the administration of anesthetic drugs, in this case - 0.5-1% lignocaine solution with epinephrine. The patient is not premedicated. After anesthesia, the doctor makes a minimum incision of 2-3 mm and, after removing the surrounding tissues, removes the varicose veins with a surgical crochet hook.

How to prepare for the miniphlebectomy procedure?

Although the miniphlebectomy procedure is performed on an outpatient basis, it must be prepared in advance. It is important that the patient before the procedure:
• has taken a shower or a bath (as close as possible to the hour of the procedure), because after the minifelebctomy has been performed, the limb cannot be soaked for 5-7 days;
• shaved his leg a few days before surgery to minimize the risk of skin infections;
• not apply cream or ointment on the limb to be treated. This applies both to the day before surgery and the day on which the miniphlebectomy is performed.
• has not taken medications that contain salicylates (such as aspirin or polopyrin), as this increases the risk of hematomas. When the patient has taken this type of drug, it is necessary to report it to the doctor.
• remember to wear comfortable clothes as they will have to slip them over a dressing.

What is the healing process after miniphlebectomy?

The healing process of minor wounds is an individual matter. However, it should be remembered that during this period the appearance of bruises and hematomas is completely normal. Small incisions made during the miniphlebectomy procedure usually heal quickly and rarely discoloration or the formation of small scars after the procedure.

Source:
• A.Rusin-Tupikowska, A. Jankowska-Konsur, A. Batycka-Baran, E. Baran, Skleroterapia piankowa, ablacja żył prądem częstotliwości radiowej, wewnątrzżylna terapia laserowa oraz flebektomia ambulatoryjna – postępy w leczeniu żylaków, „Postępy Dermatologii i Alergologii” 2009, tom VVVI, nr 6, s. 522-528
• A.A. Ramelet, Ph. Kern, M. Perrin, Żylaki i teleangiektazje, Gdańsk 2004, s.248-249

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