Hook technique (phlebectomy)

It is often not sufficient to close only the affected saphenous vein using laser or VenaSeal^®. Visible, tortuous side branches must also be removed to achieve an optimal functional and aesthetic result. This is where phlebectomy is used.

During the procedure, tiny micro-incisions of only 1–2 mm are made to insert small specialized hooks into the subcutaneous tissue. The enlarged vein is grasped, gently pulled out, and removed in sections. The procedure resembles how a blackbird pulls a worm from the ground. There are no traditional incisions, no sutures, and virtually no visible scars. The skin usually heals within a few days, and showering is generally possible again shortly after.

Phlebectomy is a proven, minimally invasive complement to endovenous saphenous vein treatment and enables aesthetically convincing results even in cases of pronounced, tortuous varicose veins.

What is the hook technique (phlebectomy)?

The hook technique – medically known as microphlebectomy or ambulatory phlebectomy – is a minimally invasive procedure for removing superficial varicose veins. Through tiny skin punctures (approx. 1–2 mm), the affected vein segments are gently extracted using a fine specialized hook. No incisions, no sutures, and usually no general anesthesia are required.

Which varicose veins are suitable for the hook technique?

It is particularly suitable for visible, tortuous side branches (branch varicosities) as well as for residual varicose veins after laser or VenaSeal^® treatment. Larger saphenous veins are usually treated beforehand using endovenous methods (e.g. laser).

How is the procedure performed?

The treatment is performed on an outpatient basis under local anesthesia. After marking the vein, tiny skin openings are made through which the vein is removed using a specialized hook. Adhesive strips are applied afterward – sutures are not required.

Is the treatment painful?

Thanks to local anesthesia, the procedure is virtually painless. After treatment, there may be a slight pulling or pressure sensation, which usually subsides quickly.

How long does the treatment take?

Depending on the extent, the procedure takes approximately 30 to 60 minutes per leg.

Will there be scars?

The skin openings are so small that they usually heal without scars or are barely visible.

How long will I be limited after the procedure?

The hook technique allows a quick return to daily life. Patients are usually mobile and able to work immediately after the procedure.

Do I need to wear compression stockings?

Depending on the findings and combined procedures, short-term compression may be recommended. However, in modern treatment concepts, compression is often not required or only needed for a very short time.

Are there risks or side effects?

As with any medical procedure, minor bruising, slight swelling, or temporary hardening may occur. Serious complications are rare when the procedure is performed correctly.

Can the hook technique be combined with other procedures?

Yes. It is very often combined with endovenous laser therapy or VenaSeal^® to optimally treat both the saphenous vein and visible side branches in a single session.