What is a Phlebectomy?

A Phlebectomy is a minimally invasive procedure that uses a small scalpel or needle to remove varicose veins on the surface of the leg. It’s highly successful when performed in patients who are good candidates along with the skilled surgeons at Greater Pittsburgh Vascular Associates. There are two basic types of phlebectomy: Ambulatory and Transilluminated Powered Phlebectomy (TIPP).

An ambulatory phlebectomy is an out-patient procedure that involves removing superficial (often large and bulging) varicose veins from the lower extremity using local anesthesia. The veins are removed through multiple, small, slit-like incisions. After the procedure, a prescription-strength compression stocking will
be placed over sterile bandages. Phlebectomy procedures are sometimes followed by sclerotherapy injections, which can be used to “clean up” the smaller, residual veins remaining.

Transilluminated Powered Phlebectomy (TIPP) is similar to ambulatory phlebectomy but slightly more invasive. It is performed on an outpatient basis in an operating room under light anesthesia. After making two small incisions near the varicose vein, the surgeon inserts a tumescent canula illuminator (TCI) that contains a fiber optic light that makes the veins easily visible. Fluid containing a local anesthetic is infused under the skin, loosening the vein from the surrounding tissue. A vein remover instrument is guided to the vein, which is suctioned into the instrument where it is cut into small pieces and removed. Thanks to the large amount of local anesthetic used, patients usually awake without any pain and are able to return home in about an hour. They can return to their normal activities immediately and to work within a few days. Strenuous activity should be limited for up to two weeks. As with any surgery, there are some potential complications including a risk of infection and hyperpigmentation (skin discoloration).