Miniphlebectomy is ideal for large varicose veins
Miniphlebectomy is now accepted as the most effective method in the treatment of large varices. In fact, the removal of large varicose veins is not a new treatment and has been practiced in the world for nearly a hundred years. However, this practice was to remove the varicose veins via large incisions made at the skin under general anesthesia, that is to say, by conventional surgery. Unfortunately, this form of treatment, which may form permanent scars on the skin, is still frequently applied in many countries.
History of miniphlebectomy
The removal of large varicose veins with mini-incisions from the skin was first described by the Swiss dermatologist Robert Müller and then became widespread all over the world. The technique of Robert Müller was to remove the varices with mini-incisions under local anesthesia that do not require suturing. This technique, which has been further developed over the years, is nowadays done via pinholes without any incision. In this technique called miniphlebectomy, first varicose veins are emptied by injecting fluid around them and then removed with special hooks through the pinholes made at the skin.
Our clinic has further developed the technique of combining miniphlebectomy with foam sclerotherapy. In this technique, which we define as ultrasound-guided miniphlebectomy, needles are first placed in large varices and saline is injected around the varices under ultrasound guidance. Thus, the venous blood in the varicose veins goes into other vessels turning the large varices into 1-2mm sized empty vessels. Then, foam sclerosant is injected via these needles into the emptied varicose veins so that both they become visible on ultrasound and sclerotherapy becomes more effective to the vein surface. These varices, which become readily visible on ultrasound thanks to the foam inside, are then easily removed with very tiny hooks placed through the pinholes.
Advantages of injecting foam during miniflebectomy: 1. Makes the process easier by making the varices visible on ultrasound, 2. empties them by causing spasm and decreases the bleeding during the procedure, and 3. treats the varicose vein segments that could not be removed and remained in the body. You can use the links below to reach our studies about this miniphebectomy technique developed by our clinic and presented at national and international congresses.