Ambulatory phlebectomy according to muller

Ambulatory phlebectomy according to muller

Phlebectomy is the removal of varicose veins by making a small incision in the skin and pulling out the varicose vein using a hooked needle. “Ambulatory” means you will be able to walk immediately after treatment. Not all varicose veins are suitable to be treated with phlebectomy. At our clinic, we usually use this method to remove the larger superficial veins. The operation is performed under local anaesthetic. The incisions are very small (2 to 3 mm), and may be “sutured” using a small adhesive plaster. Usually several incisions will need to be made (approximately every 10 cm) to remove a varicose vein completely. The treatment itself is not painful. You will feel the local anaesthetic, but that is usually not experienced as very painful.

The main advantage of phlebectomy is that the vein that has been removed will not grow back (this does sometimes occur with other methods). The disadvantage of the intervention is that you will receive small incisions in your skin. These usually heal perfectly, but sometimes some tiny scars remain visible

Prices

Muller treatment at EVLT (price per leg)
Limited: 525 euro
Advanced: 950 euro

Muller treatment loose (without EVLT) (price per leg)
Limited: 625 euro
Advanced: 1050 euro

Reimbursements

Ambulatory phlebectomy according to Muller is often no longer covered by health insurance (sometimes it is still covered by supplementary health insurance).
You must have a referral note from your GP for all treatments covered by health insurance.
If you have been referred by your GP, your first appointment for an intake interview and ultrasound (duplex) scan of the legs is covered by health insurance.

Any questions?

If you have any questions, please contact us during consultation hours at 020 8203465.

Ambulatory phlebectomy according to Muller

Ambulatory phlebectomy according to Muller is the removal of a varicose vein by making a small incision in the skin and pulling out the varicose vein with a kind of ‘hook needle’. The procedure takes place under local anaesthesia. The incisions are very small, 2 to 3 mm, and can be stitched with a band-aid. It is usually necessary to make several incisions to completely remove a varicose vein. Local anaesthesia consists of several pricks in the area to be treated with anaesthetic fluid (lidocaine). Not all varicose veins are suitable for this method; this is determined beforehand during the intake examination. The advantage of phlebectomy is that the removed vein does not return (this can sometimes be the case after injecting the vein). The disadvantage of the procedure is that you get small incisions in the skin but these usually heal very nicely, sometimes small scars remain visible. It is not detrimental to blood circulation to remove these veins: varicose veins no longer have a proper function and blood drainage has already been taken over by other veins.

Before the procedure

When you come for treatment, it is best to remain standing in the waiting room until you are called in. This is when the veins can best be seen and treated.

• We ask you not to use creams, lotions or bath oils on the day of treatment. Shaving is not necessary.
• Report anticoagulant use, and allergies to the doctor in advance.
• You may eat and drink anything before the procedure.
• After treatment, a support stocking and pressure bandage will be applied. This often involves wrapping the knee as well, which makes bending the leg difficult. Driving a car or riding a bicycle can be dangerous. Preferably take someone with you to accompany you. After 48 hours, the pressure bandage may be removed and you will be able to ride a bicycle or drive a car on your own again.
• If you have therapeutic elastic stockings, please bring them with you.
• Wear roomy clothes and shoes, space is needed for the pressure bandage.

During the procedure

In the treatment room, the varicose vein on your leg will be marked with a skin marker in an upright position. Usually, a short Duplex (ultrasound) will also be performed. You will then lie down on the treatment table and the doctor will numb the skin around the varicose vein with a number of punctures. The doctor then makes small incisions in the anaesthetised skin in a number of places. The varicose vein is looked under the skin and grasped with a hook. After this, it is gently pulled out. The procedure usually takes about half an hour; depending on the number of veins, it can also be longer. After the plasters have been applied, an elastic stocking is put on, with a local pressure bandage.

After the procedure

• Stocking and pressure bandage: a stocking and pressure bandage will be applied immediately after treatment. You may remove these yourself after 48 hours. You can then shower again. You can leave the adhesive tapes in place. You will wear the stocking for another 5 to 12 days, only during the day. The stockings can be washed at 30 degrees, so you can reuse them for any subsequent treatment.
• In the first two weeks, you are advised to exercise regularly (every hour) during the day, for example by walking, cycling or hiking. Prolonged standing is best avoided.
• Intensive sports (running, cycling, weightlifting, aerobics) are not recommended in the first two weeks after treatment, as are long car or plane trips or taking hot baths/showers/saunas.
• Zone exposure can stimulate pigmentation, use good sun protection (at least SPF 30).

Possible complications and/or side effects

• Severe pain after the procedure is not common. In case of pain, you can take paracetamol (maximum 1000mg 4x daily).
• Bruising/bleeding may occur after treatment. Sometimes a vascular remnant is left behind, which feels like a string or lump under the skin. This may be sensitive at first. This usually disappears by itself eventually. Depending on the size, this can sometimes take several months.
• A rare but possible complication after treatment is the occurrence of deep vein thrombosis. This involves a clot forming in a deep, larger vein, blocking blood flow. Symptoms that may indicate this are: a severely swollen and/or painful leg.

In case of persistent severe pain, redness or swelling, contact us.

Check-up

A check-up appointment is made after treatment, usually after 3 months.

Contact

If you have any questions or problems, please contact Medical Centre Wetering on telephone number: 020-8203465. Office hours: 08.30-16.30.

In case of emergency, the doctor can also be reached outside these hours on the same number, choice 0 from the menu.