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Medical Treatments continued...

Endoscopic vein surgery

Typically, endoscopic vein surgery is used only when varicose veins become severe enough to cause skin ulcers or sores. Your doctor will make a small cut in your skin near the vein and use a tiny camera at the end of a thin tube to move through the vein. Then he or she will use a surgical device at the camera’s end to close the vein.

Ambulatory phlebectomy 

Ambulatory phlebectomy removes varicose veins closest to the surface of the skin through slit-like incisions. You’ll remain awake during the procedure, but the area around the vein will be numbed. It's an outpatient procedure, meaning there is no overnight stay.

First, the doctor will outline or mark the vein to be removed, then inject local anesthesia into the skin. Then he or she will make a tiny cut and use a surgical instrument or a large needle to hook the vein through the opening. Next, he or she will remove the vein segment by segment. Afterward, you’ll need to wear compression stockings for at least one week.

An enhanced version called transilluminated power phlebectomy involves fewer cuts and less pain, bleeding, and scarring. Your doctor will insert a fiber optic light under your skin while at the same time injecting a saline and local anesthetic mixture. This makes a silhouette of the veins to guide placement of an instrument that cuts the vein into small pieces and suctions them out.

Vein stripping and ligation

Vein stripping and ligation, which involves tying veins shut and removing them through small cuts in your skin, is usually performed only in severe cases of varicose veins.

Vein stripping and ligation takes about two to three hours and is usually done in an outpatient setting. Full recovery takes about one to two weeks.  

Although the procedure is generally safe, risks include infection at the incision site, bruising, or irritation of a nerve that runs by the veins that are stripped.