When Is an Ambulatory Phlebectomy the Way to Go?

istock 465502058 2 1What happens when you have a varicose vein near the surface of the skin that is too large to treat with sclerotherapy but too small to treat with laser ablation? Microphlebectomy happens, and the vein goes away.

Also known as ambulatory phlebectomy or stab phlebectomy (both of which make the procedure sound kind of scary when it isn’t), microphlebectomy is an outpatient procedure with Dr. Oswalt that removes the varicose veins through small incisions in the skin. The treatment is very effective and only involves minimal recovery. Dr. Oswalt performs these procedures in our Ft. Worth offices.

Who can have microphlebectomy?

A good candidate for this procedure is a person who can walk unassisted, has normal arterial circulation, and isn’t allergic to local anesthetic options. The patient needs to be free of infections, rashes, or other skin conditions.

Prior to performing a microphlebectomy, it’s likely that Dr. Oswalt will perform an ultrasound examination to determine if your varicose veins are connected to other larger veins, which may need to be treated first. He’ll also check for clots in deep or superficial veins.

How is microphlebectomy done?

First, Dr. Oswalt will mark the veins that are to be removed. Next, he’ll inject the area with a local anesthetic. This makes the procedure painless for the patient. For the procedure, tiny incisions (only about the size of the tip of a ballpoint pen, 2-3mm) are made in the target areas. Through the incisions he inserts a surgical hook to extract the damaged vein section by section. The incisions are so tiny they normally do not require any stitches. The whole procedure takes just 45 to 60 minutes.


Patients need to wear compression bandages or stockings for a week after surgery to help minimize swelling and discomfort.  But there will be some bruising, swelling, and discomfort. This can be minimized by diligently wearing your compression stockings and using over-the-counter pain medication. Most patients can return to work the next day. Exercise and heavy lifting should be put off for two weeks.

Want to do something about your varicose veins? Call Dr. Oswalt at Fort Worth Vein Center and let’s get to work.

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