Vein stripping involves surgically removing the long saphenous vein, and is performed in the operating room. It used to be the standard of care. If you were to have a vein stripping, it would most likely be performed under a general anesthetic. This procedure is rarely performed. The standard of care transitioned to thermal ablation, an office procedure, performed using local anesthesia.

Vein stripping is mostly an antiquated procedure. I have not done this since the 1990's. Vein closure, vein Sclerotherapy, and percutaneous phlebectomy are more modern treatments.

Yes, it can be very painful.