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Incisions are made using a surgical blade. The most important instrument for this technique is the vein retractor or phlebectomy hook. There are two ways by which the veins can be grasped. Into the vein itself with a sharp instrument or around the vein with a blunt instrument. The phlebectomy hook is inserted through an incision and the varicose veins is hooked, extracted, and subsequently fixed with a clamp (e.g. Mosquito clamp). Next the vein is pulled out by turning or "wenching" the exteriorized part of the vein and moving the clamps as the vein is pulled out further. Dependent on the amount of varicose vein that has been removed the next incision is made 5 to 10 cm. along the pre-operative markings.
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This technique has been attributed to Dr Robert Muller, a Swiss dermatologist who started experimenting with this technique in the mid-1950s because he was unsatisfied with the results of sclerotherapy. Moreover, he wanted an alternative for the large eyecatching scars patients were left with after
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The procedure involves the removal of the varicose veins through multiple small 2–3 mm incisions in the skin overlying the varicose veins. First the veins are marked with the patient in standing position. Then the patient is positioned on the operating table and local anesthesia is applied.
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The procedure may be performed with tumescent or local anesthesia, such as with lidocaine. It is called ambulatory phlebectomy because patients usually return to normal daily activity immediately after the procedure which therefore may be performed in hospital or outpatient settings. Ambulatory
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General accepted indications for this technique are side branch varicose veins (semicirculatory varicose veins), varicose veins of the foot, around the ankle and the knee pit. It has been successfully used in arm varicosities and peri-ocular veins (around the eyes).
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Graded compression stockings are usually worn for 1–2 weeks after the procedure but compression bandages may also be used. This procedure is often used as an adjunct to
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De Roos, K. P.; Nieman, F. H.; Neumann, H. A. (2003). "Ambulatory phlebectomy versus compression sclerotherapy: Results of a randomized controlled trial".
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classical varicose vein surgery. After ten years of experience he demonstrated this technique during the annual meeting of the French
Phlebology Society.
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Olivencia JA (1998). "Interview with Dr Robert Muller; Father of modern day ambulatory phlebectomy".
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Muller R (1966). "Traitement des varices par la phlébectomie ambulatoire".
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if you can. Unsourced or poorly sourced material may be challenged and
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phlebectomy is considered to be more effective than
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297:Bulletin de la Société Française de Phlébologie
49:Please review the contents of the article and
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159:is a minisurgical treatment for superficial
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227:Complications are uncommon, but include
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215:or other endovenous ablations of the
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566:Extracorporeal membrane oxygenation
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561:Isolated organ perfusion technique
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328:10.1097/00042728-200303000-00004
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624:Digital subtraction angiography
649:Magnetic resonance angiography
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51:add the appropriate references
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720:Ankle–brachial pressure index
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163:and so-called side branches.
530:Endovascular aneurysm repair
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16:Treatment for varicose veins
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36:reliable medical references
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213:endovenous laser treatment
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42:or relies too heavily on
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644:Radionuclide angiography
65:"Ambulatory phlebectomy"
695:Carotid ultrasonography
639:Fluorescein angiography
674:Impedance phlebography
551:Cardiopulmonary bypass
459:Ambulatory phlebectomy
427:Carotid endarterectomy
217:greater saphenous vein
157:Ambulatory phlebectomy
129:Ambulatory phlebectomy
629:Cerebral angiography
390:Endovascular surgery
316:Dermatologic Surgery
262:Dermatologic Surgery
746:Vascular procedures
588:Seldinger technique
583:First rib resection
535:Open aortic surgery
207:Post-operative care
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578:Revascularization
268:(10): 1147–1150.
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708:Other diagnostic
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67: –
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61:Find sources:
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32:This article
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725:Toe pressure
556:Cardioplegia
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106:January 2019
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40:verification
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669:Portography
634:Aortography
616:Angiography
502:Arteriotomy
417:Atherectomy
412:Angioplasty
229:paresthesia
176:Indications
34:needs more
715:Angioscopy
683:Ultrasound
661:Venography
521:dissection
507:Phlebotomy
303:: 277–279.
247:References
237:hemorrhage
76:newspapers
185:Technique
135:Specialty
740:Category
484:Arterial
434:Stenting
385:Vascular
336:12614412
241:hematoma
233:bruising
282:9793527
194:Results
167:History
90:scholar
55:removed
490:access
488:venous
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544:Other
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97:JSTOR
83:books
486:and
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332:PMID
278:PMID
239:and
69:news
38:for
324:doi
270:doi
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