Not Your Mother’s Vein Operation

When I recommend procedures to help with venous troubles, patients frequently interrupt and ask, “Are you talking about a vein stripping? I don’t want one of those. I can remember when my mother had her veins stripped. She was in a hospital bed, in pain, with her leg wrapped for over a week. It was terrible.”

Today’s vein procedures, performed in a clinic, through micro incisions under local anesthesia are a great improvement over vein stripping operations.

When surgeons at the Mayo Clinic pioneered vein stripping in the late 1940’s, they brought much needed relief to many who had suffered for years without any available treatment. Vein stripping is the removal of the saphenous vein, the cause of varicose veins in three out of four patients. The surgeon passed a cable from the ankle, through the vein, to the groin where it was secured to the open end of the vein. The surgeon then pulled the cable out through the ankle incision bringing the vein with it. After stripping the saphenous vein, surgeons removed the remaining large surface veins (varicose veins) through multiple 3 to 8 inch incisions. The average operating time was five hours. The average blood transfusion was over two pints. Patients remained in the hospital, on narcotics, with heavily bandaged legs for a week or more.

I vividly remember my first vein stripping operation while a medical student at Wake Forest School of Medicine. It was long and bloody. My job was to hold the leg off the table and mop the blood pouring from the incisions while the surgeon pulled hard on the stripping cable to remove the vein. I had already decided that I wanted to be a surgeon but I was not looking forward to vein stripping.

Today we do not remove the saphenous vein; we leave it in place and ablate it, close it down, using radiofrequency or laser energy. We do it in the clinic using a one eighth inch incision. Patients have minimal discomfort and return to their normal activities by the next day.

We remove surface varicose veins through multiple small incisions that are usually imperceptible once healed. This procedure is called ambulatory phlebectomy. “Phlebectomy” means vein removal. ” Ambulatory “means walking, so maybe the name was chosen because phlebectomy patients are walking shortly after their procedure. I think the alternative name, micro-phlebectomy, is preferable.

If you have varicose vein problems and are putting off seeing a doctor because you are afraid of experiencing a vein stripping like your mother’s-relax. Vein treatments have come a long way in the last several years. Micro incisions. Minimal scarring. Quick recovery. Great results.

Posted in: Blog

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