Microsurgical Varicose Node Removal
Miniphlebectomy — Varicose Node Removal Through Micro-Punctures
Twisted varicose nodes that cannot be sealed from within by laser are carefully removed using specialized hooks through 1–2 mm skin punctures. The punctures are not sutured — they are closed with steri-strips and heal with virtually no trace. The procedure can be performed on its own or combined with EVLA in a single session.
1–2 mm
puncture size — no stitches needed
30–60
minutes depending on the extent of treatment
0
general anesthesia — local anesthesia only
1 day
outpatient — you walk out immediately
Who Is This Procedure For
- Large, tortuous varicose tributaries and nodes
- Nodes associated with trunk incompetence — combined with EVLA or RFA
- Veins too large for sclerotherapy
- Aesthetically significant protruding veins
Contraindications
- Acute thrombophlebitis in the treatment area — we reschedule until it resolves
- Pregnancy and breastfeeding
- Skin infections at the puncture sites
- Decompensated systemic conditions — we reassess after full evaluation
- Inability to wear compression stockings
The precise list of indications and contraindications is determined during your consultation based on vein ultrasound results.
How the Procedure Works
- 1
Marking in the Standing Position
Varicose nodes are most visible when you're upright — I mark them with a surgical pen before administering anesthesia.
- 2
Local Anesthesia
A tumescent solution is applied around the veins to be removed, ensuring a completely comfortable, pain-free procedure.
- 3
Micro-Punctures and Removal
Using a specialized hook through 1–2 mm punctures, I carefully extract the varicose vein segments step by step.
- 4
Steri-Strips and Compression
The punctures are closed with adhesive strips — no sutures needed. Compression stockings go on, and you walk home.
Benefits of the Method
Complete Removal, No Scarring
The varicose node is physically removed: no vein remains, and no noticeable scarring is left behind.
Pairs Perfectly with EVLA
We close the trunk with laser and remove the nodes through micro-punctures — full results in a single procedure.
Surgical Precision
This technique demands true surgical skill. I have been performing it since 2019, including open vascular surgery.
Outpatient Procedure
No general anesthesia, no hospital stay — you come in, we take care of it, and you walk out on your own.
Recovery: What You Need to Know
- Compression stockings as prescribed — typically 1–2 weeks
- Bruising and firmness along the treated veins is normal and resolves within 2–4 weeks
- Keep steri-strips dry for 3–5 days; I'll explain showering instructions after the procedure
- Walk daily; avoid strenuous activity and saunas for 2–4 weeks
- Follow-up exam and vein duplex ultrasound — scheduled according to your individual plan
Miniphlebectomy + EVLA = Complete Treatment in One Visit
Varicose nodes are most often caused by reflux in the main trunk vein. In such cases, I close the trunk with laser and remove the nodes through micro-punctures in a single session — one visit, one anesthesia, one recovery.
Pricing
The cost depends on the number and length of the nodes removed. When combined with EVLA, a single all-inclusive quote is provided for the entire procedure.
Miniphlebectomy
per estimate after ultrasound- The initial consultation includes a vein ultrasound and a personalised treatment plan
- Your cost estimate is confirmed in writing before the procedure and will not change
Frequently Asked Questions
Will there be any scars?
The 1–2 mm punctures are not sutured and heal under steri-strips. After a few months, the marks are barely visible — at most, small light spots that are only noticeable on very close inspection.
How is miniphlebectomy different from traditional phlebectomy?
Classic phlebectomy involves incisions, general anesthesia, and a hospital stay. Miniphlebectomy is performed through micro-punctures under local anesthesia on an outpatient basis — the same definitive result, but without sutures, a hospital room, or a lengthy recovery.
Is there pain after the procedure?
Some pulling sensations and bruising along the treated veins are possible in the first few days. Most patients find that a standard over-the-counter pain reliever for one or two evenings is more than enough — many don't need anything at all.
Can sclerotherapy be used instead of micro-punctures to remove the nodes?
Sometimes, yes — it depends on the vein's diameter and location. At your consultation, I'll walk you through both options with their pros and cons: foam sclerotherapy is less expensive and requires no punctures, but larger nodes may take longer to absorb and sometimes need repeat sessions.
When can I return to work?
For desk work, usually the next day. Walking is encouraged from day one — it's part of the recovery process. Physical labor and sports can typically resume in 2–4 weeks, based on your individual progress.
Related reading
EVLA
Laser sealing of a diseased vein through a tiny needle puncture — the leading non-surgical treatment for varicose veins.
CLaCS
A transdermal laser plus a sclerosant in the feeding vein, with skin cooling — for stubborn spider veins.
Sclerotherapy
Sclerosant injections eliminate spider veins and small vessels — no incisions, no scarring.
Vein Duplex Ultrasound
Duplex ultrasound of both legs with a full report and treatment plan — all at your very first appointment.
This material is for information purposes and does not replace a doctor’s consultation. An exact diagnosis and treatment plan are established at an in-person consultation with a vein ultrasound.
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