What is a left leg stab phlebectomy?

Left Leg Stab Phlebectomy

A left leg stab phlebectomy is a minimally invasive surgical procedure that removes varicose veins through tiny incisions in the skin, allowing for excellent cosmetic results and rapid recovery with minimal complications. 1

Procedure Description

Stab phlebectomy (also called microphlebectomy or ambulatory phlebectomy) involves:

• Making small incisions (1-3 mm) in the skin overlying varicose veins
• Using specialized hook instruments (Müller hooks or crochets) to extract the varicose veins
• Typically performed under local anesthesia in an outpatient setting
• No need for sutures in most cases
• Compression dressing applied post-procedure

Indications

Stab phlebectomy is primarily indicated for:

• Tributary varicose veins exceeding 2.5 mm in diameter 2
• Varicose veins that cause symptoms (pain, heaviness, swelling)
• Cosmetically concerning varicose veins
• As part of a hybrid approach with other venous procedures (endovenous ablation, sclerotherapy)
• Treatment of reticular veins in the popliteal fold, lateral thigh and leg 3
• Varicose veins of the ankle and foot 4

Advantages Over Other Techniques

• Lower recurrence rates compared to sclerotherapy for large varicosities 2
• Excellent cosmetic results with minimal scarring 3
• Can be performed under local anesthesia
• Immediate return to normal activities in most cases
• Avoids complications associated with traditional vein stripping 5
• Preserves normal veins that might be needed as future graft material 5

Procedural Steps

1. Patient positioning with the leg elevated
2. Marking of varicose veins while standing (pre-procedure)
3. Administration of local anesthesia
4. Creation of tiny incisions (1-3 mm) along the marked veins
5. Introduction of specialized hooks to grasp and extract vein segments
6. Application of compression dressing
7. Early ambulation encouraged post-procedure

Light-Assisted Stab Phlebectomy

A modern variation called Light-Assisted Stab Phlebectomy (LASP) combines:

• Transillumination technology to better visualize veins
• Powered and traditional stab phlebectomy techniques
• Improved visualization leading to more complete vein removal
• Reduced bruising, hematoma formation, and postoperative pain 6

Postoperative Care

• Compression therapy (20-30 mmHg) is recommended post-procedure 2
• Early ambulation is encouraged 1
• Follow-up ultrasound to confirm successful treatment may be performed
• Compression stockings typically worn for 1-2 weeks

Potential Complications

• Phlebitis (inflammation of the vein)
• Residual pigmentation
• Minor bruising or hematoma formation
• Nerve damage (rare, approximately 7%) 2
• Missed or unresected veins (10% in some series) 6
• Cellulitis (uncommon) 6

Outcomes

• High success rates with excellent cosmetic results
• Average operating room time of approximately 44 minutes 6
• Minimal blood loss (average 88 cc) 6
• Immediate postoperative complications are infrequent (approximately 10%) 6
• Effective and definitive eradication of treated veins 7

Stab phlebectomy is often performed as part of a comprehensive treatment plan for venous insufficiency, frequently combined with other procedures like endovenous ablation to address both the primary reflux source and visible varicosities 2.