Principles and Technique of Ambulatory Phlebectomy

  • Robert A. Weiss
  • Albert-Adrien Ramelet


Phlebectomy, first described by Cornelius Celsus (25 bc-45 ad), was performed until the Middle Ages. Not until the 1500s did phlebectomy resume with phlebectomy hooks illustrated in the Textbook of Surgery by WH Ryff, published in 1545.1 Lost again, this technique was rediscovered in 1956 by Dr Robert Muller, a Swiss dermatologist in private practice in Neuchâtel (Switzerland). Dr Muller developed his method,2,3 modestly calling it Celsus’ phlebectomy, and eagerly taught this technique to over 300 physicians who visited his office.4,5,6


Varicose Vein Venous Insufficiency Intense Pulse Light Chronic Venous Insufficiency Tumescent Anesthesia 
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  1. 1.
    Scholz A. Historical aspects. In: Westerhof W (ed) Leg ulcers. Elsevier, Amsterdam, 1993Google Scholar
  2. 2.
    Muller R. Traitement des varices par la phlébectomie ambulatoire. Bull Soc Fr Phléb 1966; 19:277–9Google Scholar
  3. 3.
    Muller R. Mise au point sur la phlébectomie ambulatoire selon Muller. Phlébologie 1996; 49:335–44Google Scholar
  4. 4.
    Ramelet AA, Monti M. Phlébologie, 3rd edn. Masson, Paris, 1994 (4th edn in press)Google Scholar
  5. 5.
    Ramelet AA. La phlébectomie selon Muller: technique, avantages, désavantages. J Mal Vasc 1991; 16:119–122PubMedGoogle Scholar
  6. 6.
    Fratila A, Rabe E, Kreysel HW. Percutaneous minisurgical phlebectоmy. Semin Dermatol 1993; 12:117–22PubMedGoogle Scholar
  7. 7.
    Muller R, Bacci PA. La flebectomia ambulatoriale. Salus editrice internazionale, Roma, 1987Google Scholar
  8. 8.
    Muller R, Joubert B. La phlébectomie ambulatoire: de l’anatomie au geste. Editions Médicales Innothera, Paris, 1994Google Scholar
  9. 9.
    Ramelet AA. Muller Phlebectomy, a new phlebectomy hook. J Dermatol Surg Oncol 1991; 17:814–16PubMedGoogle Scholar
  10. 10.
    Weiss RA, Goldmann MP. Transillumination mapping prior to ambulatory phlebectomy. Dermatol Surg 1998; 24:447–50PubMedCrossRefGoogle Scholar
  11. 11.
    Larson PO, Ragi G, Swandby M, Darcey B, Polzin G, Carey P. Stability of buffered lidocaine and epinephrine used for local anesthesia. J Dermatol Surg Опcоl 1991; 17:411–414Google Scholar
  12. 12.
    Vidal-Michel JP, Arditi J, Bourbon JH, Bonerandi JJ. L’anesthésie locale au cours de la phlébectomie ambulatoire selon la méthode de R. Muller. Phlébologie 1990; 43:305–15PubMedGoogle Scholar
  13. 13.
    Krusche PP, Lauven PM, Frings N. Infiltrationsanästhesie bei Varizenstripping. Phlebol 1995; 24:48–51Google Scholar
  14. 14.
    Sommer B, Sattler G. Tumeszenzlokal Anästhesie. Hautarzt 1998; 49:351–360PubMedCrossRefGoogle Scholar
  15. 15.
    Smith SR, Goldman MP. Tumescent anesthesia in ambulatory phlebectomy. Dermatol Surg 1998; 24:453–6PubMedCrossRefGoogle Scholar
  16. 16.
    Ramelet AA. Die Behandlung der Besenreiservarizen: Indikationen der Phlebektomie nach Muller. Phlebol 1993; 22:163–7Google Scholar
  17. 17.
    Ramelet A-A. Le traitement des télangiectasies: indications de la phlébectomie selon Muller. Phlébologie 1994; 47:377–81Google Scholar
  18. 18.
    Ramelet AA. One complication rare de la phlébectomie ambulatoire, le granulome silicotique. Phlébologie 1991; 44:865–71PubMedGoogle Scholar
  19. 19.
    Eichlisberger R, Moucka J, Frauchiger B, Jäger K. Ambulante Phlebektomie: das Resultat aus der Sicht des Patienten und des behandelnden Arzt. VASA 1992; 21:453Google Scholar
  20. 20.
    Desch A. Begleitverletzungen bei den neueren Techniken der Varizenchirurgie. VASA 1988; 17: 18Google Scholar
  21. 21.
    Ramelet AA. Complications of ambulatory phlebectomy. Dermatol Surg 1997; 23:947–54PubMedCrossRefGoogle Scholar
  22. 22.
    Vion B, Bun i G, Ramelet A-A. Necrobiosis lipoidica and silicotic granuloma on Muller’s phlebectomy scars. Dermatology 1997; 194:55–58PubMedCrossRefGoogle Scholar
  23. 23.
    Davis LT, Duffy DM. Determination of incidence and risk factors for postsclerotherapy telangiectatic matting of the lower extremity: a retrospective analysis. J Dermatol Surg Oncol 1990; 16:327–30PubMedGoogle Scholar
  24. 24.
    Deroos KP, Neumann HAM. Traumatic neuroma a rare complication following Muller’s phlebectomy. J Dermatol Surg Oncol 1994; 20:681–2Google Scholar

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© Springer-Verlag London 2000

Authors and Affiliations

  • Robert A. Weiss
  • Albert-Adrien Ramelet

There are no affiliations available

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