We performed our first ambulatory phlebectomy in the office this past Friday. Phlebectomy is the surgical removal of large varicose veins. I have previously performed these in the operating room of the hospital, but for less extensive procedures, the office setting is much nicer and simpler for the patient.

 
The veins are marked ahead of time. A special local anesthetic is used that numbs the area, makes the vein easier to remove and limits any bleeding. The varicose veins are removed by making a tiny punctures through the skin and inserting a small hook to catch the vein. The vein is pulled up through the puncture and removed. Pressure is held over the sights to stop any bleeding. The punctures are sealed with a steri-strip. A compression bandages are applied followed by a compression stocking.

 
Post procedure we like the patient minimize activities and keep the leg elevated for the rest of the day of surgery. After that, we encourage walking at least 20 minutes a day but to avoid strenuous activities such as running or heavy weight lifting for the next week.