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Varicose Vein Surgery / Vein Stripping

Varicose vein surgery or vein stripping used to be the primary treatment option for varicose veins. Today, with the recent development of minimally-invasive endovenous techniques (endovenous laser treatment and VNUS Closure®), which are routinely performed in-office under local anesthesia, and have similar effectiveness and easier recovery, vein stripping/ varicose vein surgery is used much less frequently. However, in certain instances (usually with very large varicose veins) it may still be indicated and appropriate.

Vein stripping (also called ligation & stripping) is commonly done under general or regional anesthesia in an operating room. An incision is made in the groin, and the problem vein is tied off at its origin (ligation). Then, a wire ‘stripper’ is inserted down the vein, and the vein is then pulled out (stripping). Remaining vein branches (from which the removed vein has been stripped) may cause some additional bleeding and bruising, but this usually subsides with time. Smaller veins may be treated afterward by sclerotherapy or other means. Possible complications of vein stripping include scarring (at the incision sites), pain, bruising, and nerve damage. Recovery usually takes one to four weeks.

Another form of varicose vein surgery is ambulatory phlebectomy. Ambulatory phlebectomy is primarily used to treat bulging, surface varicose veins. To perform ambulatory phlebectomy, local anesthetic is infiltrated around the veins to be removed, and then some very small incisions are made. A small hook is inserted into these punctures, the varicose vein is grasped and then removed. The incisions are generally so small, that there are minimal to no scars left. Ambulatory phlebectomy is often performed as an adjunct to other procedures (e.g. endovenous techniques, stripping).

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