What is varicose vein surgery?

Varicose vein surgery is a general term for different methods of surgically treating varicose veins. Varicose veins most often occur in the thighs and calves. They can look blue, twisted and bulging, and feel uncomfortable. Some people seek varicose vein surgery for cosmetic reasons to treat large and unsightly varicose veins. Others need relief from symptoms, such as burning, soreness and cramping.

Varicose vein surgery is a common but major surgery with serious risks and potential complications. You may have less invasive treatment options. Nonsurgical treatments for varicose veins include endovenous laser treatment, endovenous radio frequency ablation, sclerotherapy, and surface laser treatment. Consider getting a second opinion about all your treatment choices before having varicose vein surgery. 

Types of varicose vein surgery

Your surgeon may perform one or more types of varicose vein surgery, depending on the location and type of varicose veins that need treatment. He or she may also combine varicose vein surgery with other procedures, such as sclerotherapy, surface laser treatment, endovenous laser treatment, or endovenous radio frequency ablation. 

The types of varicose vein surgery include:

  • Ambulatory phlebectomy (also called micro-incision phlebectomy, hook phlebectomy, stab avulsion phlebectomy, and microphlebectomy) removes portions of varicose veins through small incisions using a hook. It usually takes place in a doctor’s office or outpatient surgery center using a local anesthetic.
  • Ligation and stripping usually removes the saphenous vein, a large vein in the leg. Your surgeon makes two cuts near the top and bottom of your leg. He or she will cut the saphenous vein in the upper incision, run a wire down through the vein, and pull it out of your leg through the lower incision. This surgery takes place in a hospital or surgical center using general anesthesia.
  • PIN stripping removes a vein through one incision. Your surgeon makes a cut near the top of your leg. He or she runs a device called a PIN (perforate invaginate) stripper through the cut down the vein, attaches the device to the end of the vein, and pulls the vein up through the cut. This type of surgery takes place in a hospital or surgical center using general or regional anesthesia.
  • Transilluminated powered phlebectomy (TIPP) removes portions of varicose veins using tools that your doctor inserts near the veins. They include a lighted tool that provides a better view of the vein’s location, and a cutting and suction tool that breaks up the vein and suctions it out of the leg. TIPP takes place in a hospital or surgical center using general or regional anesthesia. 

Why is varicose vein surgery performed? 

Your doctor may recommend varicose vein surgery for varicose veins that are large, protruding or unsightly. Varicose vein surgery may also be appropriate if your varicose veins are causing symptoms, such as burning, aching, soreness and cramping.  

Veins are blood vessels that carry blood from your body back to your heart. There are valves inside veins that help direct blood back to your heart. When the valves are damaged or weakened, blood can pool in your veins causing them to swell and weaken. This results in varicose veins. 

Your doctor may only consider varicose vein surgery for you if other treatment options with less risk of complications are ineffective. Less invasive options for treating varicose veins include endovenous laser treatment, endovenous radio frequency ablation, sclerotherapy, and surface laser treatment. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on varicose vein surgery. 

Who performs varicose vein surgery?

The following specialists perform varicose vein surgery:

  • Vascular surgeons specialize in the surgical treatment of diseases and conditions of the lymphatic system and blood vessels outside the heart and brain.
  • Phlebologists specialize in diagnosing and treating vein conditions including varicose veins, spider veins, chronic venous insufficiency, and vein birth defects.
  • Dermatologists specialize in the medical and surgical care of the skin, hair and nails.